Hello Prof. Hudson and friends,
Approximately 20 % of older adults have more than one chronic disease and 1/3 to 1/2 of them are on more than 5 medicines (polypharmacy) (Kane, 2011). Older adults also have risk for cognitive problems, frailty, disability, muscle loss, nutritional problems, impaired hemostasis and chronic inflammation (Kane, 2011). All these affect each other and make the situation more complex. While treating one it is possible to make a detrimental effect on the other one.
I recently have a female patient who is 82 years old. She fell down and broke right humerus and left femur and was admitted to the medical surgical floor for orthopedics surgery. She is diabetic and has coronary artery disease. She had coronary artery bypass before. She also has stage 2 kidney failure. She had an uncomplicated surgery. Post-operative she has developed an ileus, her kidney function was affected badly. Her oral intake is stopped, her protein went down, total parenteral nutrition (TPN) was started. TPN increased blood glucose level and her insulin dose was increased. She has been in the hospital since 17th of June. She is immobile more than …show more content…
Severe incontinence is seen in 5-8 % of older adults (Merkelj, 2001). Glomerular filtration rate (GFR) decreases 8 ml/minute after 50s (Weinstein & Anderson, 2010). I had a patient admitted with congestive heart failure, she had also incontinence. The provider put her on a potent diuretic which was toxic to kidney. It was not very effective either, because of decreased kidney function. She is 70 years old; this means she already lost 20 percent of GFR. In here, decreased kidney function in elderly patients played an important role in unsuccessful treatment. They tried other diuretics which increased her incontinence symptoms. These kinds of patients do not have extra reserve function and this makes their treatment more
Approximately 20 % of older adults have more than one chronic disease and 1/3 to 1/2 of them are on more than 5 medicines (polypharmacy) (Kane, 2011). Older adults also have risk for cognitive problems, frailty, disability, muscle loss, nutritional problems, impaired hemostasis and chronic inflammation (Kane, 2011). All these affect each other and make the situation more complex. While treating one it is possible to make a detrimental effect on the other one.
I recently have a female patient who is 82 years old. She fell down and broke right humerus and left femur and was admitted to the medical surgical floor for orthopedics surgery. She is diabetic and has coronary artery disease. She had coronary artery bypass before. She also has stage 2 kidney failure. She had an uncomplicated surgery. Post-operative she has developed an ileus, her kidney function was affected badly. Her oral intake is stopped, her protein went down, total parenteral nutrition (TPN) was started. TPN increased blood glucose level and her insulin dose was increased. She has been in the hospital since 17th of June. She is immobile more than …show more content…
Severe incontinence is seen in 5-8 % of older adults (Merkelj, 2001). Glomerular filtration rate (GFR) decreases 8 ml/minute after 50s (Weinstein & Anderson, 2010). I had a patient admitted with congestive heart failure, she had also incontinence. The provider put her on a potent diuretic which was toxic to kidney. It was not very effective either, because of decreased kidney function. She is 70 years old; this means she already lost 20 percent of GFR. In here, decreased kidney function in elderly patients played an important role in unsuccessful treatment. They tried other diuretics which increased her incontinence symptoms. These kinds of patients do not have extra reserve function and this makes their treatment more