Question MW is a 68 year old female with complex health needs, who has beenreferred to you for assessment and management of her conditions.Past Medical History -History of Vascular Disease, coronary bypass at 53 -Type II Diabetes (Diagnosed 10 years ago) -Hyperlipidemia -Hypertension -Atrial Fibrillation -Asthma (history of multiple emergency admissions for exacerbations) -Arthritic Knee Pain -DepressionMW retired reluctantly from her job as a Physical Education teacher 3 years ago due to her arthritic knee pain. She often feels breathlessness and has a moderate amount of ankle swelling, which she says is almost always present regardless of time of day. She has also suffered from moderately lengthy depressive episodes in the past, since her husband died suddenly and her only daughter moved out of the country.MW lives alone. She is new to your primary care practice after having the same general practitioner for 35 years. MW daughter has noted that her mother seems to have become more agitated recently when she calls. MW is reporting palpitations, large fluctuations in her blood sugar readings and some shortness of breath on exertion.Medications -Amitriptyline 25mg PO qhs -Temazepam 15mg PO qhs -Metformin 500mg PO BID -Aspirin 81mg PO daily -Digoxin 0.25mg PO Daily -Simvastatin 40mg PO Daily -Amlodipine 5mg PO Daily -Furosemide 40mg PO Daily -Telmisartan 40mg PO Daily -Tramadol 50mg q6h prn Pain -Diclofenac Extended Release 100mg PO Daily -Nitroglycerin 0.4 SL PRN Chest pain -Salmeterol Inhaler 1 inhalation BID -St John’s Wort 300mg PO TIDDenies alcohol and tobaccoNo known allergiesPhysical Assessment -Pitting edema to lower extremities -BP 160/80 -BMI 38 (clinically obese) -Blood Glucose 230 -A1C 8.7 -Cholesterol – Total 230, HDL 39, LDL 97 -Hypokalemia – K 3.1 mmol/L -Chronic Pain – poor walking ability -Shortness of breath – no wheeze audible -Liver function normal but digoxin levels are moderately high QuestionBased on the information provided in the case, please identify four medication related problems in the case and give specific recommendations in how to correct MW’s medication regimen to address identified problem. Please be specific in why you made the particular recommendations. Each of the the recommendations should address a different disease system/process. Please factor in all issues, including but not limited to: Drug-Drug Interactions, Drug Disease Interactions, and pharmacokinetics/pharmacodynamics. Please cite all references used in APA format. Please be mindful to reference appropriately and not copy and paste from references. This will be submitted as a 100-point assignment in Module 14, not a threaded post.  Health Science Science Nursing NSG 518AOL Share QuestionEmailCopy link Comments (0)

Question MW is a 68 year old female with complex health needs, who has beenreferred to you for assessment and management of her conditions.Past Medical History -History of Vascular Disease, coronary bypass at 53 -Type II Diabetes (Diagnosed 10 years ago) -Hyperlipidemia -Hypertension -Atrial Fibrillation -Asthma (history of multiple emergency admissions for exacerbations) -Arthritic Knee Pain -DepressionMW retired reluctantly from her job as a Physical Education teacher 3 years ago due to her arthritic knee pain. She often feels breathlessness and has a moderate amount of ankle swelling, which she says is almost always present regardless of time of day. She has also suffered from moderately lengthy depressive episodes in the past, since her husband died suddenly and her only daughter moved out of the country.MW lives alone. She is new to your primary care practice after having the same general practitioner for 35 years. MW daughter has noted that her mother seems to have become more agitated recently when she calls. MW is reporting palpitations, large fluctuations in her blood sugar readings and some shortness of breath on exertion.Medications -Amitriptyline 25mg PO qhs -Temazepam 15mg PO qhs -Metformin 500mg PO BID -Aspirin 81mg PO daily -Digoxin 0.25mg PO Daily -Simvastatin 40mg PO Daily -Amlodipine 5mg PO Daily -Furosemide 40mg PO Daily -Telmisartan 40mg PO Daily -Tramadol 50mg q6h prn Pain -Diclofenac Extended Release 100mg PO Daily -Nitroglycerin 0.4 SL PRN Chest pain -Salmeterol Inhaler 1 inhalation BID -St John’s Wort 300mg PO TIDDenies alcohol and tobaccoNo known allergiesPhysical Assessment -Pitting edema to lower extremities -BP 160/80 -BMI 38 (clinically obese) -Blood Glucose 230 -A1C 8.7 -Cholesterol – Total 230, HDL 39, LDL 97 -Hypokalemia – K 3.1 mmol/L -Chronic Pain – poor walking ability -Shortness of breath – no wheeze audible -Liver function normal but digoxin levels are moderately high QuestionBased on the information provided in the case, please identify four medication related problems in the case and give specific recommendations in how to correct MW’s medication regimen to address identified problem. Please be specific in why you made the particular recommendations. Each of the the recommendations should address a different disease system/process. Please factor in all issues, including but not limited to: Drug-Drug Interactions, Drug Disease Interactions, and pharmacokinetics/pharmacodynamics. Please cite all references used in APA format. Please be mindful to reference appropriately and not copy and paste from references. This will be submitted as a 100-point assignment in Module 14, not a threaded post.  Health Science Science Nursing NSG 518AOL Share QuestionEmailCopy link Comments (0)