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Original Question

Paula is a 83 Female who lives in a nursing home. Her past medical history includes mild cognitive impairment and GI bleed 8 years prior to admission. Paula is competent and makes her own health care decisions. The Nurse Practitioner ordered Omeprazole 20mg PO QAM. Paula refused the medication after reading about proton pump inhibitors. She does not feel the risks are “worth it”. A PMHNP was consulted. Which of the following is the best next step of the PMHNP? • Change the order to the trade name Nexium and add to medication list • Try often to convince Paula that she may bleed again and this medication is necessary • Discontinue to Omperazole and document in the record • Order the Omeprazole be added to Paula’s breakfast

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