For my medication reconciliation I thoroughly enjoyed doing it on my grandmother. It has been great to connect what I have learned in the classroom to the outside world, specifically around these medications. When going through her list of medications I quickly noticed some safety concerns with her medication reconciliation list. I saw that overall, her prescription of Lisinopril has many drug interactions with her current daily medication list that caused me to question other areas of my client’s care. She is on a prescription of Furosemide, as well as Prednisone, that when combined with Lisinopril can have the adverse effect of causing an individual’s blood pressure to lower. Which can cause them to feel dizzy, faint, increase of headaches and reducing their heart rate. For my client’s conditions of congestive heart failure, as well as arthritis, these medications are conducive to her health, so it is important to monitor her symptoms. Monitoring her blood pressure manually, assessing her gait, as well as educating her on taking her time when getting up suddenly and dangling her legs prior to stepping down or making any sudden movements.
My client is 93 years old, so the areas of concern for these adverse reactions with her medications are for general safety for fall risk and proper nutrition. This is based upon the fact that older adults tend to be more dehydrated and have less strength, limiting their general sense of feeling dizzy or faint. As well as being aware of Furosemide’s action of losing potassium and increasing an individual’s needs to urinate. Making sure my client includes more potassium rich foods in her diet and understands the education around urgency and incontinence while on tis medication.
I feel as though my client had a general sense of her medications. Knowing why she has been taking them and a general sense of their education, but my Aunt is one of her general care providers, her being a nurse, so my grandma relies heavily on her. This being said my grandmother is also 93 years old, so there isn’t much changing her mind on things. She knows her health, but I think is limited in her general education due to being on so many medications for so long and not having a full understanding of what the medication may or may not cause for adverse reactions.
It is very important to consider fall risk especially when your patient is 93 years old and has multiple risk factors for fractures. Great work Katie!