Pathophysiology and Pharmacology of a 94-year-old Female Patient: A Case Study

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

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NURSING
Introduction
The main scope of this assignment is to demonstrate a detailed discussion about the
patient, who is presented in the Viva Voce. The paper will mainly investigate all the
pathophysiological and pharmacological changes in relation to the patient healthcare.
Following this discussion, the paper will assess the need of the patients and will provide a
detailed recommendation for drafting person-centred care plan for the patient. At the end, the
paper will reflect on the feedback on the professional experience as provided by the
facilitator.
In relation to the basic introduction of the patient, it can be said that for confidentiality
reasons this paper will not reveal the original name of the patient and other personal details.
Written consent was taken from the patient to go through tje case notes for the assignment
before Viva voce and was thoroughly viewed by the facilitator. This paper will go with the
name Mrs. X in order to discuss about the case of a 94 year old female who lives alone in SA
housing with support from family members and friends and minimal services from the
commonwealth Home Support Program (CHSP). She was admitted at Milpara Residential
Living-ACH group due to mobility related problems on July 2018. Prior to this, she was
under care of her GP for 20 to 30 years however, during the course of time, she gradually
become confused and unsafe on her mobility so she was transferred to the aged care facility.
She has recently lost her grand-daughter due to breast cancer and is depression and her lack
of proper vision also increases her sense of depression and increase in the tendency of
accidental falls. At residential care, she was promoted to use 4WW (walker wheel) round the
clock. She also has regular/ unmodified fluid consistency and needs verbal encouragement
for increase in the intake of fluids. She is also anxious and gets easily confused about her diet
and mostly prefers sandwich.

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According to her daughter, she has frequent loss of memory and has sleep anpea,
diabetes along with low potassium level of the body. Her past medical history also included
hypertension, hyperlipidaemia, atrial fibrillation and vitamin B12 deficiency and Glaucoma.
Her current medications include Alprazolam, Amlodipine, Pantroprazole, Karvezide, Eliuis
and Atorvastin along with Duro-K Slow release tablets. The future discussion about the
pathophysiology and pharmacological changes leading to her admission is discussed below.
Pathophysiology/ Pharmacology
The primary concern is increased in the tendency of the accidental fall. The main
underlying factor behind increase in her tendency to accidental fall is her age. According to
Ambrose, Paul and Hausdorff (2013), people who are above 65 years of age have increased
tendency of accidental fall due to slippage of loss of body balance. Mrs. X is 94 years also
and according to the narration highlighted in the case study, Mrs. X has unsteady gait and has
difficulty in rising from the seated position and recurrent falls at homes. Ambrose, Paul and
Hausdorff (2013) highlighted that major risk factors, which are identified behind the
increased tendency of fall among the older adults include gait, polypharmacy and previous
history of accidental fall. Other risk factors include advancing age, visual impairments,
vfemale gender, cognitive decline in attention and executive dysfunction. After age of 40
years there occurs menopause in women, this further hampers the bone health and increases
the tendency of developing osteoporosis. Menopause or perimenopause decreases the
secretion of estrogen and this cause loss in the bone mass and bone fragility (Manolagas,
O'brien and Almeida 2013). Mrs. X also has dementia and this demented condition is another
reason behind her increased in the tendency of fall. According to Jansen et al. (2015),
dementia is a symptom of a variety of specific structural brain disease, which leads to the

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degeneration of the neural impulses along with impairment in the neurotransmitter. This
imbalance in the neurotransmitter leads to difficulty in the hand eye co-ordination leading to
the increase in the tendency of accidental fall. Mrs. X also had previous case history f
Glaucoma, which might also increase her vision loss with age (Bourne et al. 2013). Jansen et
al. (2015) further highlighted that dementia hampers the cholinergic neurons and gradual
destruction of the pyramidal cells in the cerebral cortex, which creates difficulty in moving
joints increases the fall tendency among older adults. Mrs. X past medical history also
indicated that she has Vitamin B deficiency. Dai and Koh (2015) argued that nutrient
deficiency mainly accelerates the bone loss thereby leading to osteoporosis that increases the
propensity of fall. Mainly calcium and vitamin D are regarded as the pillars of maintaining
bone health however, the several reviews have highlighted that Vitamin B also plays a major
role in regulating bone health. Vitamin B has a direct relation with the biomarkers, which
decreases bone mineral density and increases in the risk of osteoporosis (Bailey et al. 2015).
Her current problems also include diabetes and hyperlipidaemia and hypertension. It
is due to her hypertension of high blood pressure, her current medication include amlopinine.
Amlopinine is an angioselective calcium channel blocker which inhibits the influx of the
calcium ions into the vascular smooth muscles and thereby helping to inhibit the contraction
of the health muscles and the vascular smooth muscles which in turn reduces the blood
pressure (Joshi and Bansal 2013). Another medication that is given to Mrs. X in order to
reduce blood pressure is Karvezide. From the present condition of Mrs. X indicates that she
has the tendency of developing cardiac complication as she has high blood concentration of
lipid, high blood pressure and high blood sugar level. According to Marso et al. (2016), high
blood glucose level damages the blood vessels and nerves that control heart functioning
which increases the tendency of heart attack. Moreover, people like Mrs. X are more
vulnerable in developing cardiac complication because, she has high blood pressure, she has