Case Study for the Assignment: LM is an 89-year-old female resident of a long-t

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Case Study for the Assignment:
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:
Weight: 129 lbs
Height: 64 inches
BP: Supine = 177/82
HR: 78 bpm
LABS:
TSH 2.45 SCr 0.9 Hgb 11.9
Free T4 0.98 BUN 42 Hct 34.1
Na 135 Cr: 1.6 Plt 255
K+ 3.8 UA: Clear
Cl 99 eGFR: 45 ml/min
CO2 25 WBC 7.0
Glucose 101 RBC 4.5
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 the last 12 months.
PAIN ASSESSMENT:
Faces pain scale: No pain occurs at rest; upon walking, pain is moderate to severe.
To Prepare
Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
Review the case study assigned by your Instructor for this Assignment.
Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
Think about how you might improve the patient’s 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.

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.
Please be reminded that the sources used should be credible (.gov, .edu, and .org), and include evidence-based literature. Many of the (.gov, .edu, and .org) sites are used for background information and clinical decision-making.
Note: When selecting articles for course assignments, you are advised (unless you are referencing seminal information) to focus on work published within the past five years.

WRITING STYLE AND FORMAT
Please write the assignment in APA format
Use subheadings to indicate which part of the Question is being answered.
Include an introduction (with the thesis statement and the purpose of the paper), plus a conclusion.
Make sure to use a minimum of five current (less than 5 years old) resources: at least 3 from the school materials and 2 from outside.
APA style headings are to be used appropriately to separate and organize sections of the paper.
Direct quotes are discouraged and should only be used when the source material uses particularly striking or notable language.
The introduction should provide an overview of the topic, the purpose of the paper, and the topics that will be addressed.
The body of the paper needs to address all required topics.
The conclusion should provide closure for the reader, synthesize the content, and tie everything together to help clarify the paper’s main points.
The reference page should include all references cited in the assignment in the correct APA format.
Some course assignments may require the use of more than two credible outside resources.
Credible sources include scholarly peer-reviewed journal articles, evidence-based resources, and professional (.org), educational (.edu), and government websites (.gov). Assignments and discussion SHOULD NOT only include patient-facing websites (for example, CDC, MayoClinic, Statpearls, MERCK, etc.). Commercial websites (.com) are not considered credible sources. Please note: When selecting articles for course assignments, you are advised (unless you are referencing seminal information) to focus on work published within the past five years.
LEARNING RESOURCES
Required Readings
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.Chapter 33, “Review of Hemodynamics” (pp. 285–289)
Chapter 37, “Diuretics” (pp. 290–296)
Chapter 38, “Drugs Acting on the Renin-Angiotensin-Aldosterone System” (pp. 297–307)
Chapter 39, “Calcium Channel Blockers” (pp. 308–312)
Chapter 40, “Vasodilators” (pp. 313–317)
Chapter 41, “Drugs for Hypertension” (pp. 316–324)
Chapter 42, “Drugs for Heart Failure” (pp. 325–336)
Chapter 43, “Antidysrhythmic Drugs” (pp. 337–348)
Chapter 44, “Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels” (pp. 349–363)
Chapter 45, “Drugs for Angina Pectoris” (pp. 364–371)
Chapter 46, “Anticoagulant and Antiplatelet Drugs” (pp. 372–388)
ACC/ACHA: https://www.jacc.org/guidelines
Guideline on the Management of Blood Cholesterol
Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults
Guideline on the Primary Prevention of Cardiovascular Disease
Guideline for the Management of Patients With Atrial Fibrillation
Guideline for the Management of Heart Failure
Strategies to Enhance Application of Clinical Practice Guidelines in Patients With Cardiovascular Disease and Comorbid Conditions
Effectiveness-Based Guidelines for the Prevention of Cardiovascular Disease in Women
Guideline for the Evaluation and Management of Patients With Syncope

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