Case Study:
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
⢠Alzheimerâs 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
Assignment
⢠Review the case study assigned by your Instructor for this Assignment.
⢠Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
⢠Explain on how the factor you selected might influence the patientâs pharmacokinetic and pharmacodynamic processes.
⢠Explain how changes in the pharmacokinetic and pharmacodynamic processes might impact the patientâs recommended drug therapy.
⢠Explain how you might improve the patientâs drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.
Sample Solution
cognitive skills. The cognitive skills that are getting improved by playing with legos are fine motor skills and math skills (Sri). Legos come in a vast range of shapes and sizes, which can lead to twisting and turning a childâs hands, fingers, and arms. This promotes coordination and dexterity which are needed for children for crafts, handwriting, and dressing themselves. Legos also help in a childâs math skills because children need to learn how to add, subtract, multiply, or divide how many pieces they need for their creation. A study has been done to see if Legos actually increase cognitive development. There were two groups of kids and one group was able to play with legos for a month and the other group was not able to play with Legos. After the month, the kids were put through a series of tests to see how well their fine motor skills developed. Through the study, it was seen that the kids, who played with Legos for a month, had a significant increase on their cognitive development. Second, Legos are able to strengthen a childâs emotional skills. Legos are able to help aid in a childâs emotional development by giving them a sense of accomplishment and to teach them persistence. With the sense of accomplishment, children are able to feel a sense of pride after they create something, which can lead to an increase in self-confidence. Legos are able to teach children persistence because Legos are small, which can lead to mistakes. This allows the children learn to cope with the frustration of mistakes and to keep on building until they get it right. Lastly, Legos can help in social skills by cooperating with peers. Children can cooperate with peers to build something together. Legos have also been able to serve as a foundation for future careers. They can serve as a foundation because children that have played with Legos are already exposed to skills needed in future careers. By developing a childâs math skills and ability to follow intricate directions, this has allowed for future engineers and architects to flourish in their fields. An example would be how a womanâs daughter has been able to use her past experiences with Legos to be able to use them in her job being an architect. She was able to recall past designs she made with Legos and implemented them in the buildings she designs now(Cooke). Legos have also aided people in art careers. Legos help children explore their creativity by being built into whatever they can imagine. There are now artists that focus on mainly using Legos to create pieces of art.>
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cognitive skills. The cognitive skills that are getting improved by playing with legos are fine motor skills and math skills (Sri). Legos come in a vast range of shapes and sizes, which can lead to twisting and turning a childâs hands, fingers, and arms. This promotes coordination and dexterity which are needed for children for crafts, handwriting, and dressing themselves. Legos also help in a childâs math skills because children need to learn how to add, subtract, multiply, or divide how many pieces they need for their creation. A study has been done to see if Legos actually increase cognitive development. There were two groups of kids and one group was able to play with legos for a month and the other group was not able to play with Legos. After the month, the kids were put through a series of tests to see how well their fine motor skills developed. Through the study, it was seen that the kids, who played with Legos for a month, had a significant increase on their cognitive development. Second, Legos are able to strengthen a childâs emotional skills. Legos are able to help aid in a childâs emotional development by giving them a sense of accomplishment and to teach them persistence. With the sense of accomplishment, children are able to feel a sense of pride after they create something, which can lead to an increase in self-confidence. Legos are able to teach children persistence because Legos are small, which can lead to mistakes. This allows the children learn to cope with the frustration of mistakes and to keep on building until they get it right. Lastly, Legos can help in social skills by cooperating with peers. Children can cooperate with peers to build something together. Legos have also been able to serve as a foundation for future careers. They can serve as a foundation because children that have played with Legos are already exposed to skills needed in future careers. By developing a childâs math skills and ability to follow intricate directions, this has allowed for future engineers and architects to flourish in their fields. An example would be how a womanâs daughter has been able to use her past experiences with Legos to be able to use them in her job being an architect. She was able to recall past designs she made with Legos and implemented them in the buildings she designs now(Cooke). Legos have also aided people in art careers. Legos help children explore their creativity by being built into whatever they can imagine. There are now artists that focus on mainly using Legos to create pieces of art.>
