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S. STABLES, OACPP Older Adult in the Community Process Paper Sloane Stables NURS 440: Nursing Care of the Older Adult Family Tarleton State University December 5, 2016 1
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S. STABLES, OACPP Integrative Statement The primary concern of J.A. is his activity intolerance. He has a history of complete independence and is constantly frustrated by his newfound lack of movement and mobility. J.A. has a medical history of Congestive Heart Failure (CHF), Atherosclerosis, and nasal polyps. He has had a mitral valve repair, bilateral ankle fusion, spinal fusion, nasal polyp removal, and shoulder surgery. His activity intolerance is attributed to his spinal fusion, mitral valve repair, and his bilateral ankle fusion. J.A. has an extensive medication list consisting of Warfarin, Fenofibrate, Atorvastatin, Metoprolol Tartrate, Bumetanide, Montelukast, and Benicar. Warfarin, an anticoagulant, inhibits clotting factors to prevent the formation of drug clots. It is prescribed to my patient for maintenance of his CHF and to prevent clots from forming after his recent mitral valve repair. Common side effects of Warfarin include nausea, loss of appetite, stomach or abdominal pain, and bleeding; J.A. stated that he often does not feel hungry and only eats because he knows he is supposed to. Fenofibrate is a medication that helps to increase HDL and decrease LDL levels in the blood, especially in patients with atherosclerosis. Common side effects of Fenofibrate include mild stomach pain, back pain, headache, or a runny or stuffy nose. J.A. admitted to frequently having a "stiff" back. Atorvastatin increases HDL and decreases LDL levels in the blood to treat high cholesterol and prevent cardiovascular diseases, such as Coronary Artery Disease or a heart attack. Common side effects include headache, hoarseness, lower back or side pain, periorbital pain or tenderness, painful or difficult urination, and a stuffy or runny nose. As mentioned previously, J.A. stated that he frequently has a "stiff" back, but denies experiencing any other symptoms. Metoprolol Tartrate, a beta-blocker, dilates the blood vessels to decrease the workload on the heart. It is used to treat chest pain and hypertension, as well as prevent a heart attack. Common side effects include blurred vision, chest pain or discomfort, confusion, orthostatic hypotension, shortness of breath, slow or irregular heartbeat, sweating, or unusual weakness. J.A. stated that he frequently feels lightheaded when he changes positions too quickly. Bumetanide is a loop diuretic that prevents the body from absorbing too much salt and fluid, and is commonly used to treat edema in CHF. Side effects include flushed skin, joint pain, stiffness, or swelling, loss of appetite, mood or mental changes, shortness of breath, and dizziness. J.A. states that he often has joint pain and stiffness but attributes it to being an "old man"; he also frequently does not have an appetite, and sometimes feels dizzy when changing positions too quickly.
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  • Spring '18
  • Sinusitis, Diuretic, J.A.

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