Running head: PHARMACOLOGY CASE STUDY
Pharmacology Case Study
Kimberly Johnson
Columbus State University
Professional Clinical Nursing RN I
NURS 3191
Professor A. Hawkins
September 21, 2013
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Pharmacology Case Study
Medication administration in a safe and effective manner, play a huge factor in elderly
patients. According to recent research, “People are more likely to develop one or more chronic
illnesses with advancing age, and appropriate medication can help seniors live longer and more
active lives” ("Pfizer," 2011). There are many safety concerns associated with older adults and
it’s dangerous not to follow the directions for medication administration. Some of the causes for
seniors not following the medication guidelines include: taking three or more medications,
including nonprescription medicine and herbal or dietary supplements, live alone, fill
prescriptions at more than one pharmacy, use both online and community pharmacies, prescribed
prescriptions from more than one physician, and have memory problems or not as sharp as they
use to be ("Pfizer," 2011). Patient education regarding medication administration and health
conditions assist with improving patient outcomes. The use of additional resources to assist the
elderly will decrease the knowledge and memory deficit and allow elderly patients to take
medications in a safe and effective manner.
When the patient presents to the Emergency Room (ER), there is much education that
should be provided to the patient. The first thing however that should occur is to stabilize the
patient. After stabilization takes place, education should then be provided to the patient. It may
be important to educate the client with a family member at bedside if possible. The patient needs
to be first explained that Diabetes Type II is the most common form of diabetes and with type II
diabetes, your body does not use insulin properly ("American Diabetes Association," 2013).
Next she should be explained on when to take her blood sugars. She needs to be educated that
she should not be taking her blood sugar every third day but needs to take it daily. I would also
educate the client that she should write a log of what her blood sugars are daily to bring in during
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her routine clinic visits. This will provide the physician the opportunity to determine if the
current diabetic plan is working properly. I next would educate the client that her blood sugar
should be 70-130 before meals and less than 180 1-2 hours following meals ("American Diabetes
Association," 2013). An HgA1c result of 9.2 is high, and indicates that the patient is not
managing her blood sugars appropriately. A normal target level for HgA1c is 7 percent or less.
The patient needs to be educated on the importance of taking her Metformin. Metformin is used
to treat type II diabetes and the dosage may vary depending on the blood sugar ranges. If the
patient cannot afford to purchase the metformin, other resources should be provided to assist the
patient with obtaining the medication or suggesting her primary care physician change the
prescription to something that the patient can afford that will work as effective as Metformin.
The patient needs to also be educated that it is not recommended that she obtains her
blood pressure when she goes grocery shopping. Blood pressures (BP) should be obtained at
rest. “Blood Pressure is the force of blood pushing against the walls of the arteries as the heart
pumps blood ("NIH," 2012). The patient needs to understand that her BP can be elevated if
taken while completing activities or task and usually is more accurate when taking after resting.
Normal range is less than 120 systolic and less than 80 diastolic. Stage I is 140-159 systolic and
90-99 diastolic. Stage II is defined as a systolic of 160 or higher and diastolic of 100 or higher. I
would educate the patient that readings in the 140’s-160’s systolic and 88-100 diastolic is
considered not within normal range. I would then educate the client that we can’t be sure if her
BP is accurate if she is not taking them at the appropriate times. I would then explain to the
patient that Zestril (Lisinopril) is used for treatment of hypertension, heart failure and heart
attacks. The dosage prescribed would also depend on the provider. I next would explain to the
patient that Zocor (simvastatin) is used for treatment of cholesterol, the dosages range according
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to the physician and the medication can be taken with or without food. I would also educate the
patient that it is recommended that she not eat large amounts of grapefruits while taking the
prescribed medication. Prilosec (omeprazole) is a proton pump inhibitor (PPI) used for
gastroesophageal reflux. Its function is to decrease the amount of acid produced in the stomach
("drugs.com," 2013). The medication dosage will vary according to the physician. I would
complement her that her reflux is well controlled and encourage her to continue taking her reflux
medication as prescribed.
I would then provide the patient with available resources to assist her since she lives at
home alone. Case Management may be able to provide the patient with assistance to receive
home health care to ensure the patient is taking medications at appropriate times. The use of
home health care can often times delay the admittance of long term care facilities. The patient
also needs to be educated that even though she wants to help her son with his child support so
that he does not go back to jail, it needs to be explained that taking her medications as prescribed
is very vital to her health and she needs to obtain her medication first before helping her son. I
would also encourage the patient since she drives, to seek medical advice if she is unsure of
when or how to take prescribed medications.
While providing patient education to seniors/elderly can be difficult, it plays a key factor
in maintaining a longer life span. It is important to assist them with available resources to ensure
that they take their medications correctly. It is most important that healthcare professionals
ensure that the patient or a family member understands the purpose of taking the prescribed
medication. The patient can be provided with educational videos, reading literature (if the
patient is able to comprehend) and ensure the patient can verbalize and demonstrate appropriate
medication administration and when to obtain blood sugar for possible medication
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administration. Ensuring that elderly/senior patients are educated will allow for economy growth
and development. As healthcare professionals, we should all work together to provide the
patient with optimal care to lead to increasing knowledge and potentially a longer life span.
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References
Living with Diabetes. (2013). Retrieved September 20, 2013, from
http://www.diabetes.org/living-with-diabetes/treatment-and-care/
Medication Safety for the Elderly: A guide for patients and caregivers. (2011). Retrieved
September 21, 2013, from http://www.pfizer.com/files/health/medicine_safety/46_Med_Safety_for_Elderly.pdf
What is High Blood Pressure? (2012). Retrieved September 21, 2013, from
http://www.nhlbi.nih.gov/health/health-topics/topics/hbp/
What is Prilosec? (2013). Retrieved September 21, 2013, from
http://www.drugs.com/prilosec.html