An 80-year-old patient is brought to the emergency department after fainting at home- EMS verbalized that the client was alone, and it appears that he lives
alone- When arriving to the ED his serum digoxin level is 2-5 ng/mL- He is transferred to a medical telemetry nursing unit- The next day, the nurse asks the
patient to tell her about his routine for taking his daily digoxin tablets- The client verbalized problems hearing the nurse- The nurse rephrased her questions-
After being asked several times, he states that he was told to check his pulse every morning before taking a pill- He does this in his kitchen because the clock
on the wall has big numbers and he can see the second hand go around- The nurse asks him how long he measures his pulse- He replies “I keep counting
the beats until I get to 60- Sometimes it takes a longtime- Then I take my heart pill-” Later he tells the nurse that he hates “having so many pills to take” and
admits having trouble remembering to take his pills- He states that he sometimes can’t remember which pills to take with breakfast and which to take at night- I
sometimes take medication when I get up to use the bathroom at night-” I am really not sure which one it took, it was dark-”
Insurance: Medicaid and Medicare
Other Medications: Simvastatin 2omg PO daily, Lasix 2omg PO daily, Lisinopril 2omg PO daily, Tamulosin 0-4mg daily-
Current Medical history:
CHF
Hyperlipidemia
HTN
Osteoarthritis
COPD
Past Medical History:
Smoker of 25 years
01. From the history and data presented above what type of physiological changes has occurred? Described the changes- (1opt)