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Ms. Wamser is an 87-year-old woman with a hx of hypertension, hypothyroidism and advanced dementia consistent with Alzheimer’s type dementia. She experienced a gradual functional decline and lost her ability to ambulate (FAST 7c) over the past 3 months and is non-verbal and dependent for all ADLs with fecal and urinary incontinence. She was hospitalized 2 weeks ago for an aspiration pneumonia but has improved and currently resides in a skilled nursing facility consuming approximately 25% of her meals. She has experienced increasing diarrhea, intermittent vomiting, and worsening anorexia over the past 6 weeks. Her family has opted to pursue hospice care and you are the medical director reviewing her medication list which is as follows: Acetaminophen 500 mg q 4 hours prn pain Amlodipine 10 mg PO daily Donepezil 10 mg PO in evening Levothyroxine 50 mcg PO daily Memantine 10 mg PO BID Mirtazapine 15 mg PO daily Which of the following is the best management option to relieve her symptoms? a. Discontinue her amlodipine b. Discontinue her levothyroxine C. Start loperamide 2mg every 4 hours as needed d. Taper off her donepezil
SCIENCE
HEALTH SCIENCE
NURSING

 
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