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Medication safety issues
The nurse is visiting a 78-year-old client in the home. The client has type 1 diabetes mellitus, hypertension, and osteoarthritis in both knees. The client's sight is moderately impaired despite the use of eyeglasses. The client's medication regimen includes Humulin insulin 70/30 (combination insulins) 35 units subcutaneously in the morning, lisinopril (Zestril) 5 mg by mouth daily, and nabumetone (Relafen) 500 mg by mouth twice daily.
What are 2 important medication safety issues the nurse will assess in the client?
What measures can the nurse suggest to the client to ensure accuracy and compliance with the medication regimen?
The client reports feeling "dizzy" at times. How will the nurse evaluate this concern?
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Computer Science |
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Answer
Measures To Ensure Accuracy and Compliance
Insulin injection demands for manual administration of the dosage of the insulin and requires the individual to inoculate into the abdomen. The patient’s age together with his or her inability to see brings about medication safety concerns for the patient. Therefore, to ensure accuracy and compliance, the nurse should recommend the use of insulin pump that works similarly as pancreas and takes insulin to the body automatically after every meal. This device is free from all forms of human errors and eradicates cases of improper dosage administration. Another way of ensuring accuracy and compliance is by substituting the normal vials with vials of various sizes or shapes. As indicated in the case study, the patient has reduced visibility in his eyes and is unable to differentiate between two vials of medication. Therefore, putting the two oral medications in two vials with different sizes or shapes would assist in the easy differentiation of the medications and preventing the possible mixing of the medication.
The patient in the study takes insulin injections for treating type 1 diabetes mellitus, linisopril for hypertension and nabumetone for osteoarthritis. He experiences reduced visibility in his eyes even after putting on glasses, a situation that has made it difficult to differentiate between medications. Some of the side effects of these drugs include dizziness, abdominal pain, as well as, diarrhea (Modi, 2007). Therefore, the nurse should advise the patient to stop standing up from resting position or sitting from lying position once the medication has been administered. If possible, the patient should try getting up gradually from the siting position. Secondly, the nurse should establish patient’s blood pressure to determine whether the anti-hypertensive drugs might be contributing to the decline in the blood pressure that consequently causes dizziness.
References
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Kaushal, R., Bates, D. W., Landrigan, C., McKenna, K. J., Clapp, M. D., Federico, F., & Goldmann, D. A. (2001). Medication errors and adverse drug events in pediatric inpatients. Jama, 285(16), 2114-2120.
Modi, P. (2007). Diabetes beyond insulin: review of new drugs for treatment of diabetes mellitus. Current drug discovery technologies, 4(1), 39-47.
Riddle, M. C. (2008). Combined therapy with insulin plus oral agents: is there any advantage?: An argument in favor. Diabetes care, 31(Supplement 2), S125-S130.
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