Medication Regimen: Helen Evans’ Case

Introduction

In order to complete the medication regimen paper, Helen Evans and her medication story were chosen to be analyzed. The patient is female, and her age is 65 years old. The woman has serious problems with her health state, and her medical story contains the following diagnoses: hypertension, diabetes mellitus, hypothyroidism, GERD, atrial fibrillation, and heart failure. It is vital for her to take appropriate medications and receive comprehensive treatment on an everyday basis in order to maintain her condition and prevent aggravation of the situation.

All the aforementioned health problems require an individual approach and a particular range of medicines. All of them have their specialties, for instance, apart from the prescribed medication, diabetes mellitus is highly recommended to be accompanied by a balanced diet. In addition, the medication should be taken during a meal. Other illnesses should be treated in their own way as well. For example, Levothyroxine, which is intended to coping with an underactive thyroid gland, should be taken strictly on an empty stomach. Therefore, the patient needs an appropriate medication regimen in order to regulate the intake of all the medicines at the correct time.

Helen Evans presents a perfect case in this regard, as she needs to treat numerous health problems at the same time on a regular basis. In addition, her case is relatively widespread, as her problems are typical in her age. Consequently, the purpose of this paper is to comprise the most effective and appropriate medication regimen for this patient, including all the individual specialties and requirements for usage.

List of the Current Medications

Lisinopril 20 Mg-Hydrochlorothiazide 25 Mg Tablet Angiotensin Inhibiting Agents

• Time of day and dose: Daily, by mouth. 20/25 mg.
• Medication class: Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor, and hydrochlorothiazide is a diuretic.
• Mechanism of action: It lowers high blood pressure via two medications, which are lisinopril and hydrochlorothiazide. Lisinopril helps to relax blood vessels, and blood can transmit through the organisms freely, while hydrochlorothiazide eliminates extra salt and water out of an organism.
• Client’s indicated use: The patient takes an appropriate dose in the mornings every day.
• Major side effects: In the period when an organism adapts to the medication, there is a likelihood of the appearance of dizziness, tiredness, lightheadedness, and headache. In addition, the risk of losing too much water and salt (minerals).
• Nursing implications: It is appropriate to reject taking the medication and appoint a physician in case of hypersensitive response. It is not advisable to drive or participate in hazardous activities until the reaction to the medication is clear. A healthy and balanced diet is highly recommended, including sodium and potassium restrictions.
• Client teaching: The medication should be taken by mouth in accordance with the doctor’s recommendation. It is not advisable to change the dose or miss pills.

Metformin

• Time of day and dose: Twice a day by mouth. 500 mg.
• Medication class: Biguanide
• Mechanism of action: The medication is intended to control high blood sugar for patients with type II diabetes. Metformin accompanies an appropriate diet and a physical activity program.
• Client’s indicated use: The patient takes an appropriate dose by mouth in the mornings and evenings with meals every day.
• Major side effects: Possible side effects are nausea, vomiting, weakness, diarrhea, and there is a likelihood of the appearance of a metallic taste in the mouth. In addition, stomach upset are characteristic in the period of the beginning of the treatment.
• Nursing implications: The medication is appropriate for overweight patients for whom dieting is not effective for treating diabetes. It can also be applied in case sulphonylurea treatment is not resultative.
• Client teaching: In order to prevent gastrointestinal problems, it is crucial to take the medication with meals. It should be taken in accordance with the doctor’s recommendation without interruptions.

Toprol XL

• Time of day and dose: Daily, by mouth. 100 mg.
• Medication class: Beta-blocker
• Mechanism of action: The medication is applied to treating chest pain (angina), heart failure, and high blood pressure.
• Client’s indicated use: The patient takes an appropriate dose by mouth in the evenings with meals or immediately after a meal at the exact time every day.
• Major side effects: Drowsiness, weakness, dizziness, tiredness, and slow heartbeat are possible side effects.
• Nursing implications: It is not recommended to reject taking the medication abruptly after long-term therapy. Moreover, the patient should swallow the whole tablet without chewing or crushing it.
• Client teaching: The patient should take the medication in a prescribed dose during or immediately after a meal at the same time every day. The capsule should be swallowed whole without breaking and opening it.

Levothyroxine

• Time of day and dose: Every morning, by mouth. 0, 25 mg.
• Medication class: Hormone
• Mechanism of action: The medication is intended to coping with an underactive thyroid gland, which produces the thyroid hormone. Levothyroxine supplies the defect, which is vital for proper mental and physical activity.
• Client’s indicated use: The patient takes the prescribed dose by mouth in the mornings on an empty stomach, approximately an hour or half an hour before a meal.
• Major side effects: At the beginning of the therapy, there is a likelihood of hair loss. This consequence is temporary, and after several months body adapts to the medication.
• Nursing implications: Levothyroxine should be taken without mixing with other medications. Moreover, it should be taken on an empty stomach, as even coffee may interfere with its function.
• Client teaching: The patient should take the medication strictly on an empty stomach and alone. In addition, missing a rill is not appropriate, as it is crucial to maintain a hormone balance.

Prilosec

• Time of day and dose: Every morning, by mouth. 0, 20 mg.
• Medication class: Proton-pump inhibitors.
• Mechanism of action: The medication is applied in case it is needed to treat a particular stomach or esophagus illnesses, for instance, acid reflux and ulcers. It relieves hardships with swallowing, heartburn, and cough.
• Client’s indicated use: The patient takes the prescribed dose by mouth in the mornings every day.
• Major side effects: There is a likelihood of the appearance of headaches and abdominal pains.
• Nursing implications: The medication should be taken in a diapason from half an hour to an hour before a meal. A patient should not break a capsule, it should be swallowed whole.
• Client teaching: A patient should be aware of recommendations on avoiding taking medication during meal or alcohol drinking. Moreover, the capsule should be taken whole without dividing it into parts.

Eliguis

• Time of day and dose: Twice a day, by mouth. 5 mg.
• Medication class: Apixaban
• Mechanism of action: The medication contributes to avoiding blood clots and, as a result, minimizes the likelihood of stroke.
• Client’s indicated use: The patient takes the prescribed dose by mouth twice a day, namely in the mornings and evenings.
• Major side effects: There is a likelihood of the appearance of nausea, easy bruising, and bleeding in minor forms.
• Nursing implications: The patient should take the medication in accordance with the prescription. The patient should be acquainted with the signs of bleeding.
• Client teaching: The patient should take the prescribed dose of the medication without missing it. In case of missing, the medication should be taken as soon as possible. The double doses should also be avoided, and the rejection of the medication should be discussed with a healthcare provider.

Furosemide

• Time of day and dose: Every day, by mouth. 20 mg.
• Medication class: Diuretics
• Mechanism of action: The medication is applied to minimize the amount of extra fluid in an organism. In addition, it is helpful for treating high blood pressure.
• Client’s indicated use: The patient takes the prescribed dose by mouth in the mornings every day.
• Major side effects: In the period of adjusting to the medication, there is a likelihood of the appearance of dizziness, lightheadedness, and headaches. In addition, blurred vision may occur at the beginning of taking the medication.
• Nursing implications: To minimize dizziness and lightheadedness, it is advisable to rise for a lying or sitting position slowly and without abrupt movements. Moreover, it is essential to monitor BP, vital signs, S&S of hypokalemia, I&O ratio and pattern, urine, and blood glucose & HbA1C.
• Client teaching: The patient should appoint for a physician and discuss appropriate slat and fluid intake. It is recommended to stick to a potassium-rich diet. The patient should change body position slowly and without abrupt movements.

Tylenol

• Time of day and dose: Every 4 hours as needed for pain, by mouth. 450 mg.
• Medication class: Analgesics and antipyretics
• Mechanism of action: The medication is intended to reduce fever and minimize the pain from mild to moderate forms.
• Client’s indicated use: The patient takes the prescribed dose in case of pain.
• Major side effects: The medication is usually not recorded to have side effects.
• Nursing implications: It is not recommended to change the dose of the medication. In case of hypersensitivity, it is advisable to reject the medication.
• Client teaching: The patient should not exceed the prescribed dose and take it for more than 10 days. The medication should be stuck to only in case of appropriate complaints.

Vitamin C

• Time of day and dose: Every day, by mouth. 500 mg.
• Medication class: Vitamin
• Mechanism of action: Vitamin C is vital for the proper function of the organism and may benefit the treatment in a great number of ways. In the case of the patient, it is intended to supplement medication, which lowers the high blood pressure, and decrease systolic blood pressure.
• Client’s indicated use: The patient takes the prescribed dose by mouth in the evenings every day.
• Major side effects: Vitamin C is considered to be safe, and side effects are not frequent. Nausea, vomiting, headache, stomach cramps may occur, though it is not highly likely. The amount over 2000 mg may be unsafe and lead to side effects, such as kidney stones and diarrhea.
• Nursing implications: It is advisable to take laboratory tests, which are Periodic Hct & Hgb, serum electrolytes. Moreover, S&S of acute hemolytic anemia and sickle cell crisis should be monitored.
• Client teaching: The patients should be aware of recommendations on avoiding high doses of vitamin C.

The patient is required to take the aforementioned list of the medications in order to address all the health problems. They allow controlling all the symptoms and supplying a conformable living, though they do not provide the solution for the diseases. In addition, a complex medication regimen was prescribed to the woman, which includes all the specialties about each medication. Thus, none of the items prevent the action of others. For this reason, the regimen may be considered balanced.

Non-Prescription Medications

Although the list of the medication is comprehensive in coping with all the health problems of the patient every day, there is a likelihood that she will need some medicines out of the list. In case of colds and flu, Helen Evans prefers to adhere to the medication on the plant base. In case of viruses, the patients prefer to take Rimantadine HCL, which is helpful for downplaying the symptoms and reducing the time needed to recover (Web MD, n. d.). It is also applied whether the woman feels that there are risks of getting flu (Web MD, n. d.). The medication should be taken separately from the treatment course of the patients, and it is considered not to have significant side effects (Web MD, n. d.). It is highly likely not to interfere with the work of other medicines. Moreover, all the additional vitamin intakes should be discussed with a physician in order to match a diabetic’s diet.

In addition, occasionally, the patient may have a necessity to address the problems with the digestive system. In this case, Pancreatin Tablet, which includes digestive enzymes, can be applied. It should be taken separately, without mixing with other medications, as it can increase the likelihood of side effects. Furthermore, it should not be taken with Prilosec at the same time, as the latter cannot be combined with medications.

Patient and Family Teaching

The patient should take the prescribed dose of each medication in the list without exceeding or minimizing it by mouth. It is important to pay attention to the recommendations on the period, when a medication should be taken. Firstly, it is crucial to take Levothyroxine in the morning, strictly on an empty stomach, 30-60 minutes before a meal. Metformin should be consumed during the meal, as it controls the level of sugar in the blood and without interruptions. Toprol XL should be swallowed whole during or immediately after a meal at the same time every day. Prilosec should not be combined with other medications, as they may interrupt its functioning. All the diuretics should be taken in the first half of the day in order to avoid sleepless nights. These recommendations are essential to be followed, as they supply the comprehensive treatment of the patient.

The patient should be aware of all the major side effects, and in case of worsening the health state, it is strongly advisable to appoint a physician. Moreover, a range of medications are intended to cope with high blood pressure, so Helen Evans should avoid abrupt movements. She should changes her lying and sitting positions slowly, as there are risks of lightheadedness and dizziness. Furthermore, the woman should undergo medical tests on a regular basis.

The indicators, which should be monitored are the level of sugar in the blood, BP, vital signs, S&S of hypokalemia, I&O ratio and pattern, urine, and blood glucose & HbA_1C. As the patient has diabetes mellitus, it is crucial to stick to an appropriate diet. Sugar in food and long distances between meals should be avoided, and alcohol should not be taken regularly as well (Shepherd et al., 2017). In addition, physical activity on an everyday basis is highly recommended.

Predictions about Medication Adherence

Helen Evans is aware of all of her health problems, and she is interested in improving her lifestyle. All the prescriptions and pieces of advice on medication intake are explained to her in detail. In addition, her family provide the patient with essential care and contributed to her treatment. She lives with her husband George, who helps her to monitor the health state and controls the adherence to the medication regimen. The spouses are supplied with the telephone number of the physician in order to contact him in case of urgent questions or aggravation of the condition. Helen is also visited by her children and grandchildren regularly.

The financial state of the family does not raise any concerns, they can afford to purchase all the necessary medication, pay for the insurance and medical service. For these reasons, she can be considered responsible enough to follow all the recommendations, and the family supports her in this regard (Yap et al., 2016). Therefore, there is a high likelihood that the patient will adhere to the regimen. However, due to specialties of her age and a range of requirements, she should be reminded of undergoing medical tests regularly.

Specific Issues about the Patient

There are some specialties, which should be taken into consideration while treating the patients. Ten years ago, Helen Evans had a right leg breakage. The bones are not capable of recovering properly at this age. Therefore, this fact influences her activity level to a large extent. As compared to other elderly women, the patient cannot maintain an appropriate level of physical activity. However, she is recommended to stick to such a form, which is convenient for her due to diabetes mellitus. For instance, it is advisable to adhere to walks in the parks twice a day.

Moreover, the patient has weather sensitivity, and all the weather changes affect her condition. She may have headaches, weakness, and tiredness on rainy days. In case of sudden changes in weather conditions or climate, Helen Evans is likely to have dizziness and lightheadedness. This fact is essential to be taken into consideration in case of any complaints about the side effects of the medications. In general, she is advised to stay in a wild and warm climate in order to maintain activity and health.

In addition, the woman is not resilient to stresses, and the aforementioned symptoms may appear due to serious worries and disappointments. There is also a likelihood of a heart attack in case of serious stress. For this reason, a calm and peaceful environment is highly recommended to the patient. This factor should also be drawn attention to in case of any complaints on the side effects of medications.

References

Rimantadine HCL (n. d.). Web MD. Web.

Shepherd, E., Gomersall, J., Tieu, J., Han, S., Crowther, C., & Middleton, P. (2017). Combined diet and exercise interventions for preventing gestational diabetes mellitus. Cochrane Library. Web.

Yap, A. F., Thirumoorthy, T., & Kwan, Y. H. (2016). Medication adherence in the elderly. Journal of Clinical Gerontology and Geriatrics, 7(2), 64-67. Web.