Mr. and Mrs. Brady Bunch (Brady 8-12-35 and Betty 7-4-32) have recently moved into the long-term care center where you are attending clinical. They have six children, two in the immediate area, and 14 grandchildren.
Brady has always been a very proud man, raised in the post WWII generation, asking for very little assistance and stoic with his emotions-unless it involves his wife of 67 years. His occupation was construction architect, and he was named Father of the Year following an essay by his daughter, Marcia. He has been followed by his general practitioner for COPD, he was a smoker for 60 years, and for BPH. He does present with pre-diabetes, controlled with diet. Height 5’7” Weight 143 lbs. Allergies: NKA (no known allergies) MD: Dr. Zhivago.
His medications include1. :1. Tamsulosin (generic) Flomax (brand) 0.4mg po (by mouth) once daily, 30 minutes after am meal. (he does note min dizziness-a common side effect of Flomax)2. 2. Acetaminophen 325 mg 1-2 tablets as needed for pain, every 4 hours.3. Albuterol (ProAir-brand) inhaler every morning and evening and every 4 hours as needed for SOB, dyspnea.
Betty is a different story and she is the reason that they have moved into the couple’s units at the LTC facility. She is a very sweet lady, who was a stay-at-home mother, who was very involved in her Lutheran church. She has been diagnosed with early dementia, congestive heart failure (following many years of HTN), and hypothyroidism. She experiences lower extremity edema with mild
pain secondary to her decreased vascular circulation, and CHF. Her height is 5’1”, Weight 145 lbs. and she is Allergic to: PCN. MD: Dr. Zhivago.
Her medications include:1. Synthroid 75 mcg po every morning (without food)2. Acetaminophen 325 mg 1-2 tablets as needed for pain every 6 hours.3. HCTZ 25 mg po every morning (hold if systolic blood pressure < 100 or diastolic < 60 and notify MD)4. 4. Digoxin (generic) Lanoxin (brand) .125 mg po every morning (hold if apical pulse rate < 60 and notify MD)
Please come up with three nursing diagnosis, one problem oriented and one at risk for, for each of the Brady’s. Write your nursing Dx. out in the preferred format. Choose one medication for each of them and research it. Tell me the class, mechanism of action, reason for taking, and nursing concerns for that medication.