Running Head: CASE STUDY FOUR

Case Study Four
Julia McGraw
Lakeview College of Nursing
N-309 Nursing of the Gerontological Client
June 12, 2011

CASE STUDY FOUR                                                                                                                     1
Case Study Four
     All of Mrs. Tyler’s medications have the possibility of causing a fall.  Prozac can cause drowsiness, tremor, dizziness, and poor concentration (O’Brian, 2011, p. 514).  Her Os-Cal dosage is above the recommended dosage, so her calcium levels should be closely monitored.  If the levels get too high, she could have hypercalcemia, causing confusion (O’Brien, 2011, p. 227).  She is also on Aricept, this drug can cause dizziness, syncope, seizures, and drowsiness (O’Brien, 2011, p. 410).  Zantac has the possibility of causing her to have confusion, hallucinations, blurred vision, and dizziness (O’Brien, 2011, p. 977).  Her Ecotrin medication can cause dizziness, drowsiness, confusion, hallucinations, and seizures (O’Brien, 2011, p. 167).  She is also on Mellaril.  This drug can cause confusion, dizziness, drowsiness, and blurred vision (O’Brien, 2011, p. ).  Lastly, her Valium can cause dizziness, confusion, tremor, drowsiness, hallucination, orthostatic hypotension, and blurred vision (O’Brien, 2011, p. 380).
     Mrs. Tyler’s hallucinations and altered mental status could both be from drugs.  It is especially probable that these symptoms were caused by drugs because of the sudden onset and her daughter stated that the behavior had not happened in the past.  Mrs. Tyler is on Demerol, which has been know to cause confusion (Mauk, 2010, p. 267).  Mrs. Tyler is also on Promethazine.  This medication can cause confusion and euphoria (O’Brien, 2011, p. 942).
     I would alter her drug regimen.  I would talk to her physician about changing her pain medications, so her hallucinations would be stopped and her mental status would be back to normal.

CASE STUDY FOUR                                                                                                                  2
References
.
Mauk, K. L. (Ed.). (2010). Gerontological nursing: Competencies for care (2nd ed.). Sudbury, 
     MA: Jones and Bartlett.
O’Brien, N. (Ed.). (2011). Mosby’s nursing drug reference (24th ed). St. Louis, MO: Mosby 
     Elsevier.