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Original Question

This is a two-part case study. You must complete both parts. Do not forget to reference your work. Case Study information: Mr. Farnsworth is a 78-year-old male who was admitted to the ER after falling at home. He was not found until 2 days later by his son, Paul. Mr. Farnsworth is diagnosed with a right hip fracture and severe dehydration and is scheduled for surgery tomorrow. Mr. Farnsworth is on 50ml/hr of Normal Saline via IV after receiving 1000 ml over 4 hours in the ER for rehydration. He is also on morphine IV 4mg/hour. Mr. Farnsworth’s son Paul states, “My dad has had some problems with his blood pressure but he always takes his medicines. I get them refilled for him from Dr. Jeffers.” Paul is able to tell you that Mr. Farnsworth was on the following medications prior to his fall. 81 mg aspirin, one daily by mouth (Diovan HCT) 160mg/12.5 (Valsartan/Hydrochlorothiazide) one daily by mouth Metoprolol 100mg, twice daily by mouth Atorvastatin 40 mg, one daily by mouth at bedtime. Part 1 Answer the following questions regarding Mr. Farnsworth. You will then go to Part 2 of the case study. 1. What are the side effects/ adverse effects of ALL the medications Mr. Farnsworth has been taking listed below? 81 mg aspirin, one daily by mouth (Diovan HCT) 160mg/12.5 (Valsartan/Hydrochlorothiazide) one daily by mouth Metoprolol 100mg, twice daily by mouth Atorvastatin 40 mg, one daily by mouth at bedtime 2. Which medication being taken by Mr. Farnsworth, either currently or prior to his fall, causes the greatest concern at this time? 3. By reviewing Mr. Farnsworth’s medications, how severe is his hypertension? 3 Part 2 Mr. Farnsworth’s surgery was successful. 5 days later you are discussing his possible discharge to a rehabilitation center. Mr. Farnsworth is not happy regarding being placed in a rehabilitation center and states, “I know I will need help for a while but it seems to me that once you go in an old folk’s home you never come out.” As you review Mr. Farnsworth’s medications with him Mr. Farnsworth states, “I take those pills every day and Paul knows all about them, but I also take some others I don’t want my son to know about.” Mr. Farnsworth states, “I have been depressed ever since I lost Paul’s mother. He doesn’t know I take these medications. I don’t want him to think his father can’t handle things. I worry though, sometimes I wake up and I am in bed but dressed to go out.” He then tells you he is taking the following medications: Fluoxetine (Prozac) 80 mg in two (2) divided doses, by mouth, daily. Zolpidem (Ambien) 10mg by mouth as needed for inability to sleep. Answer the following questions regarding Part 2 of the case study. 1. What statement by Mr. Farnsworth should concern you regarding his safety and which medication is the likely cause for this concern? 2. Paul, Mr. Farnsworth’s son asks if you could teach him about the medications his father is taking. What medications would you include in your teaching and how would you teach Paul to give these medications. DO NOT restate the side effects/adverse effects.

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