Case study: Mrs. Hernandez is a 78-year-old female who lives alone in her own home. She frequently complains of feeling dizzy when she wakes up in the morning and when she gets out of her chair. She describes feeling light headed and has visual difficulties. Her past medical history is significant for diabetes type 2, congestive heart failure, hypothyroidism, atrial fibrillation, angina and major depression. Her current medications include sertraline 50mg daily, nortriptyline 25mg, levothyroxine 0.1mg daily, warfarin 5mg daily, furosemide 20mg twice a day, glipizide 5mg daily, prn acetaminophen, prn meclizine (25mg q 8 hours). She has been having difficulty sleeping and was recently prescribed diphenhydramine 50mg prn at night. She has been taking the diphenhydramine for the past few nights and feels like she is sleeping better. She has admitted that she sometimes does not take her “water pill” even though “they think I do” because she has to get up too frequently to go to the bathroom. She is looking forward to going to a family outing in two weeks but worries about the dizziness, “I don’t want to be a burden and ruin everybody’s fun.”
What are your concerns? What is the cause of your concern?
What else do you need to know about the situation? What other assessment and /or information do you need to obtain to get a holistic understanding of the situation?
Identify Mrs. Hernandez’ modifiable risk factors.
What strategies would you implement to reduce fall risk? Explain why you chose these strategies.
What tools and resources would you recommend? Provide rationale for your recommendations.
You can submit a written response to these questions (Limit your response to 3-4 double-spaced pages)
