Mr. B

Mr. B, a 70-year-old male client, presented to his primary care physician with complaints of blurred vision and headaches over the last two months. On several visits, Mr. B’s blood pressure was found to be elevated, so the physician started him on hydrochlorothiazide 25 mg by mouth daily. One month later, Mr. B began to have chest pains and shortness of breath, so his primary care provider referred Mr. B to a cardiologist for further evaluation.

The cardiologist ordered an echocardiogram and stress test which revealed heart enlargement and a reduced ejection fraction (volume of blood pumped out of the heart per minute). As a result, the cardiologist started Mr. B on a beta-blocker (metoprolol 25 mg by mouth daily).

A few days after taking the new medication (in addition to the hydrochlorothiazide ordered by the primary physician), Mr. B suffered a fall at home. Upon arrival at the emergency room, Mr. B’s blood pressure was 80/50. The emergency room physician suspected the cause of Mr. B’s fall was hypotension secondary to the medications he was taking. The ER physician recommended that Mr. B follow up with his primary care physician and cardiologist, but hold the medication until seen by them.

As recommended, Mr. B visits his primary care physician for a follow-up. During the visit, Mr. B’s blood pressure is found to be elevated (160/90), so his physician tells Mr. B to restart taking his blood pressure medication.

Imagine that you are the nurse attending to Mr. B and that he indicates that he’s afraid to restart the medication because of his recent fall.

1. What considerations/actions should the nurse make regarding the client’s refusal to restart his blood pressure medication?
2. What considerations/actions would have helped the healthcare team to prevent the client’s fall? 

ALL IN APA FORMAT WITH REFERNCESS

         Emerging issues concerning the Neglect of the Disabled Elderly population. 

• Discuss the aspects of your chosen vulnerable population. (The Elderly And Disabled Elderly )
• Discuss the reason why is this group considered vulnerable.
• Discuss what are the most common communicable diseases in this population, and why.
• Discuss barriers to healthcare and access to care for your vulnerable population.
• Use information technology to identify resources that will improve health outcomes of the vulnerable population.
• Examine evidence based practices that improve health outcomes of the vulnerable population.
• Discuss how the issues this group is facing relates to the community/public health nursing.
• Minimum 10 slides, including speaker notes, the title and reference slides.

As an advanced practice nurse, you will likely experience patient encounters with complex comorbidities. For example, consider a female patient who is pregnant who also presents with hypertension, diabetes, and has a recent tuberculosis infection. How might the underlying pathophysiology of these conditions affect the pharmacotherapeutics you might recommend to help address your patient’s health needs? What education strategies might you recommend for ensuring positive patient health outcomes?

For this Discussion, you will be assigned a patient case study and will consider how to address the patient’s current drug therapy plans. You will then suggest recommendations on how to revise these drug therapy plans to ensure effective, safe, and quality patient care for positive patient health outcomes.

CASE STUDY HH is a 68 yo M who has been admitted to the medical ward with community-acquired pneumonia for the past 3 days. His PMH is significant for COPD, HTN, hyperlipidemia, and diabetes. He remains on empiric antibiotics, which include ceftriaxone 1 g IV qday (day 3) and azithromycin 500 mg IV qday (day 3). Since admission, his clinical status has improved, with decreased oxygen requirements. He is not tolerating a diet at this time with complaints of nausea and vomiting.

Ht: 5’8” Wt: 89 kg Allergies: Penicillin (rash)

To Prepare

Review the Resources for this module and reflect on the different health needs and body systems presented.

Your Instructor will assign you a complex case study to focus on for this Discussion.

Consider how you will practice critical decision making for prescribing appropriate drugs and treatment to address the complex patient health needs in the patient case study you selected.

Post a brief explanation of your patient’s health needs from the patient case study you assigned. Be specific. Then, explain the type of treatment regimen you would recommend for treating your patient, including the choice or pharmacotherapeutics you would recommend and explain why. Be sure to justify your response. Explain a patient education strategy you might recommend for assisting your patient with the management of their health needs. Be specific and provide examples.

Note:

1 page

APA format

3 references not more than 5 years

Musculoskeletal Disorder Concept Map. Prepare a concept map for a musculoskeletal disorder from your readings. Use the included template outline to system disorder including the path o physiology, etiology and clinical manif 

Healthy aging is an important public health issue, both nationally and internationally.  Discuss how social determinants of health for the older adult are impacted for those living in poverty.  

The World Health Organization (WHO) recognizes healthy aging as a process whereby all people of all ages are able to live a healthy, safe and socially inclusive lifestyle.