Assignment task: Penny is a 67-year old woman who has presented to the emergency department of your hospital with a 3-day history of shortness of breath on exertion. She reports it has been getting worse for the past 3 days and she only came in to hospital today because she was having trouble walking from the bedroom to the bathroom, a distance of approximately 10 metres, whereas before she could manage to get around her house well. Otherwise, she says she "would've just put up with it."
Penny has a past medical history including:
- Angina - diagnosed 12 years ago;
- 3 acute myocardial infarctions (AMIs) - 10 years, 7 years and 3 years ago;
- Her body mass index (BMI) is 34 kg/m;
- She has smoked a pack of cigarettes per day for the past 47 years;
- She admits to minimal exercise; and,
- Due to financial reasons, she eats fast food up to 5 days per week.
Penny has brought her current medications with her and, when you ask her about her dosage, frequency and reason for taking them, she says that she takes one every morning and knows "most of them are for her heart."
Her current medication regimen is documented as:
- Furosemide, 40 mg twice a day
- Enalapril, 5 mg twice a day
- Telmisartan, 20 mg in the morning
- Carvedilol, 12.5 mg twice a day with food
- Digoxin, 62.5 micrograms twice a day
- Slow K 3 tablets, in the morning
- Atorvastatin 40 mg, every night
- Paracetamol 1 g, as required
- Metoclopramide 10 mg, as required
The following questions will be related to this case.
1. Give THREE pieces of information that you need to teach Penny and provide a rationale for why this is important for her to know
2. Choose ONE drug from her medication list and provide TWO assessments you will do before administering the medication. Provide the rationale for each