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QUESTION
Noncompliant Patient
- As the home health nurse, I would explain my duties to Ms. C which include assisting her with any
basic needs such asbathing, dressing, and medication management.I will go over the plan of care that
has been made for her and inform her ofall the medical team. I will ask Ms. C what difficulties she faces
when administering her medications. Verbal communication isan important skill for building rapport and
trust between patients and home health-care professionals ( de Guzman, A. B., Jaurigue,K. A. M., &
Jimenez, A. A. B. 2019). Ms. C currently has four differently health issues which all require different
medication.
Ms. C may have memory loss which may contribute to her not being compliant with her medications.
Older adults havemore difficulty remembering newly presented information such as word lists, specific
details of events, or the context inwhich something occurred ( Zelinski, E. M., Dalton, S. E., & Hindin, S.
2011). Also another factor that can cause a problem can be eye sight. Ms. C may not be able to read her
prescription bottles and may be consuming less medication. Ms. C is diabeticand insulin is typically
prescribed for diabetic patients. It is very important to get the exact units of insulin in the syringe andbeing
able to administer it throughout the day with meals. Ms. C is also taking medication for hypertension. If
she is missingher doses that can attribute to her having another myocardial infarction in the future.
It is important to be able to figure out a plan so that Ms. C will be able to take her medications as
prescribed. If If there areno health barriers that prevent her from taking her medication, then a daily pill
organizer can be helpful. Also, setting upalarms on her cell phone or alarm clock can be a way to help her
remember. An alternative option can be having a CNA sitwith her throughout the day to help her with the
medications.
- As a home health nurse, I would approach Mrs. C by first, advising her of the risk factors of
not taking her medications. I feel some medication education would be helpful, and really focus
on the main reason for taking them. I can also ask her questions like does she want to manage
her health? I would ask that because she is older. Does she feel able to care for herself? I can
approach Mrs. C by comforting her that I am there to help. The article mentioned how some
elder feel about healthcare “While talking about their participation in home care, elderly persons
report a feeling of being useless now that they are old” (Bagchus, Dedding, & Bunders, 2014).
I then could share with her of the risk factors that are associated with not taking her medications
properly. The risk factors that might interfere with Mrs. C’s plan of care are her age. Being that
she is 72 years old it leads to further assessments. Does Mrs. C know how to properly take her
medications, is there a greater issue with her remembering to take her medications. Another risk
factor is do her diseases play a factor in her not being able to take her medication. Maybe she
doesn’t feel good take them.
I can evaluate if Mrs. C can manage her care alone. I can assess if the heart attack (myocardial
infarction) played any role in changing Mrs. C ability to do things on her own. I also would do
some assessments. Check the Mrs. C’s vitals, blood pressure, and blood sugar. According to
the article “The most critical factors in the medication safety of the elderly are the polypharmacy,
drug interactions, side effects of the medicines, medicines that should be avoided owing to the
medical state of the patient and several medicines with different trade names” (Metsälä &
Vaherkoski, 2013).
| Subject | Nursing | Pages | 4 | Style | APA |
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Answer
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Response 1
Dear,
Thank you for an informative and detailed post based on Ms. C condition. I agree with you that a good rapport with the patient is very significant and forms one of the foundations of treatment procedures. As stated by Madula et al. (2018), the moment there is a good association between a healthcare provider and the patient, the patient always opens up and reveals important information that are imperative for care and treatment procedures. People within the age bracket of Ms. C have issues with drug compliant. This is because some lack the ability to read accurately hence end up taking wrong doses. Additionally, in the event that old people take more than one prescription, there are high changes that they can confuse one dose and prescription for another drug. It is in this context that a proper care is required, especially during time of taking drugs.
Reference
Madula, P., Kalembo, F. W., Yu, H., & Kaminga, A. C. (2018). Healthcare provider-patient communication: a qualitative study of women’s perceptions during childbirth. Reproductive health, 15(1), 1-10.
Response 2
Dear,
Thank you for a detailed post. I concur with you that patient education is one of the most important factors during treatment plan. As stated by Yajnik et al. (2019), education informs the patient of what is required of him or her. It highlights the do’s and don’ts. As such, in this particular case, it will enlighten Ms. C on the need to comply with prescription and time of taking her drugs. However, it is important to note that at her age, forgetting and confusing the drugs, especially when drugs are more than two is very common. In fact, studies suggest that cases of non-compliant to drugs are higher in older people than younger ones. Therefore, other than educating Ms. C, it is important that she gets close care particularly during times of taking her drugs.
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References
Yajnik, M., Hill, J. N., Hunter, O. O., Howard, S. K., Kim, T. E., Harrison, T. K., & Mariano, E. R. (2019). Patient education and engagement in postoperative pain management decreases opioid use following knee replacement surgery. Patient education and counseling, 102(2), 383-387.