Case Study: Kathryn Freeman Kathy Freeman is

Case Study: Kathryn Freeman Kathy Freeman is a 78-year-old obese female with a history of major depressive disorder, generalized anxiety disorder, degenerative joint disease, diabetes type 2, asthma, and hypertension. She also has a long history of substance use disorder (alcohol). Approximately 25 years ago Kathy went through a time of rehabilitation and relapse, and now has been sober for 14 years. She continues to smoke one pack per day. She lives alone in a small apartment. She is divorced and has no children. Kathy was hospitalized for an elective knee replacement (TKA) which initially went well, but on post-operative day one she had an ischemic cerebral vascular accident (CVA) that resulted in moderate left sided weakness and swallowing difficulty. Past Medical History Medications Major Depressive Disorder Generalized Anxiety Disorder Asthma Tobacco Use Disorder Hypertension Diabetes Mellitus Type 2 Morbid Obesity History of Substance Use Disorder (alcohol- sober for 14 years) Fluoxetine (Prozac) 40mg po daily Lisinopril (Prinivil) 20 mg po daily Hydrochlorothiazide (HCTZ) 25mg po daily Metformin (Glucophage XR) 500mg po twice daily Albuterol MDI 2 puffs every 4 hours PRN Aspirin 81mg po daily Ibuprofen 400mg-600mg po every 6 hours as needed for pain Enoxaparin 30 mg subcutaneously twice daily (for a total of 10 days) Rivaroxaban (Xarelto) 20 mg po daily St. John’s Wort (OTC) 900 mg po twice daily (currently on hold) No known diagnosed allergies (NKDA) It is now post-operative day 4 and Kathy is being discharged to a Transitional Care Unit (TCU) tomorrow. You are working on medication reconciliation and discharge planning. Questions: You notice that one provider had ordered diphenhydramine (Benadryl) for Kathy as needed for sleep but that was quickly discontinued; she never took a dose. Who may have advised that diphenhydramine is not a good medication for Kathy, and why isn’t it recommended? (Explain your answer. Hint: the AGS 2019 Pocket Guide BEERS criteria posted in the Week 6 module is helpful). When a hospitalized client is prescribed a medication, which roles are involved? List 3 health care professionals who are involved in the process of prescribing the medication through the process of medication administration to the client and briefly describe their roles.

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