History of present illness: F.S. is an 87-year-old male patient recently admitted to a skilled nursing facility for rehab after suffering a cerebrovascular accident (CVA) and subsequent seizures. He has left-side hemiparesis, aphasia and mild cognitive impairment from the CVA. He is a 2 assist transfer. In addition, he has just been diagnosed with a urinary tract infection (UTI).
Past medical history: Atrial fibrillation, hypertension, type 2 diabetes mellitus, rheumatoid arthritis
Medications:
Warfarin 5 mg PO daily with evening meal
Lisinopril 40 mg PO daily
Metoprolol XL 50 mg PO daily
Aspart 7 units SQ three times daily with meals
Glargine 20 units SQ daily at HS
Prednisone 10 mg PO daily
Phenytoin 100 mg PO three times daily
Ciprofloxacin 500 mg PO two times daily x 7 days
1. Why is F.S. taking each of the medications he is currently prescribed?
Medication
Rationale
Warfarin
Lisinopril
Metoprolol
Aspart
Glargine
Prednisone
Phenytoin
Ciprofloxacin
2. Should the nurse be concerned about any drug-drug, drug-disease, or drug-lab interactions?
3. What are the priority assessments the nurse should perform prior to administration of F.S.’s medications? Provide the rationale for each assessment.
4. What labs should be monitored? Provide the rationale for each lab.
5. After considering the adverse effects of all the medications prescribed, what 5 adverse effects should the nurse prioritize when monitoring Fred?
6. What is a priority nursing diagnosis for F.S.?
