Describe how changes in the processes might impact the patient’s recommended drug therapy.

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Case Study 2
LM is an 89-year-old female resident of a long-term care facility who has been experiencing multiple falls, some resulting in injuries such as bruising and skin tears. Over the last 6 months, her ambulation status has declined from independent to wheelchair level. She complains of pain in her legs when walking more than short distances across the nursing unit.
PMH:
HTN
Alzheimer’s disease
Hypothyroidism
Osteoarthritis
Diabetes
MEDICATIONS:
Amlodipine 10 mg QD
Donepezil 10 mg QHS
Levothyroxine 0.88 mg QAM
Celecoxib 200 mg QD
Furosemide 40 mg QAM
Metformin 500mg, 1 BID
Glyburide 5mg, 1 BID
ALLERGIES: NKA
SOCIAL HISTORY:
Widowed with 2 adult children living in town, retired photographer and owner of an art supply store
VITALS: LABS:
Weight: 129 lbs TSH 2.45 Free T4 0.98
Height: 64 inches Na 135, K+ 3.8, Cl 99, CO2 25,
BP: Supine = 177/82 Glucose 101, SCr 0.9, BUN 42
HR: 78 bpm WBC 7.0, RBC 4.5, Hgb 11.9, Hct 34.1
Plt 255
Cr: 1.6 UA: Clear
eGFR: 45 ml/min
PE:
HEENT: Normocephalic, no evidence of trauma, PERRLA, EOMI, Dry mucous membranes
CV: RRR
Respiratory: Clear to auscultation bilaterally
Abdomen: Soft, non-tender, no masses or guarding
G/U: Skin intact, assisted with toileting and personal hygiene by staff
Extremities: Bilateral 2+ edema to lower extremities; skin dry, dark bruising and skin tear to right elbow and forearm
Neuro: Alert and oriented to person only. MMSE 18/30, stable over last 12 months.
PAIN ASSESSMENT:
Faces pain scale: No pain occurs at rest, upon walking, pain is moderate to severe
Posted by: Carman Silver
Posted to: NURS-6521N-33-Advanced Pharmacology-2022-Spring-QTR-Term-wks-1-thru-11-(02/28/2022-05/15/2022)-PT27
Scholarly Sources Reminder
Posted on: Friday, March 4, 2022 3:24:54 PM EST
Walden University expects students in all programs to demonstrate scholarly writing abilities. We understand that many of our students are returning to a degree program after many years or perhaps are even seeking higher education for the very first time, and that this can be an overwhelming journey. We offer many resources to support you as you work to become an advanced scholar-practitioner. With so much information available, it can be difficult to determine which sources are most appropriate and which are to be avoided. Here are a few tips to help you navigate.
What are reputable sources of content for my assignments?
Personal thoughts and experiences. Some assignments ask that you reflect on your personal experiences in your chosen field, as well as the goals you have for your education and career. It is appropriate in these instances to use your own words.
The assigned course text and course readings
Articles and references obtained via the Walden library
Additionally, all scholarly resources should be properly cited and referenced to give credit to the original source and author. Any content that is not your own must be synthesized or quoted, and you should avoid any direct copying and pasting.
What sources should I avoid?
Informal blogs, internet posts, and websites that are not part of a scholarly review process. This includes popular hospital websites (such as MayoClinic.org), Patient facing websites with information designed for the patient, not the provider (such as WebMD, Healthline, MedicineNet, MedlinePlus, and MerckManual (commercial version) among many others), and UptoDate.com. Information should not be utilized from UptoDate.com since all information is a synthesis of the most up to date literature available. If you wish to use information from UpToDate, use the original sources, not the UpToDate website.
Cheating websites. Sites that ask you to pay for content or submit your own work in order to “unlock” content or resources are not a reputable source of information.
Another student’s work. Regardless of where it is obtained, the use of another student’s written work is never appropriate. This includes use of another student’s work as a “reference”, or exemplar assignment. Templates and examples are often provided in the classroom.
Write a 2- to 3-page paper that addresses the following:
Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

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