The Older Adults

      An 80-year-old patient is brought to the emergency department after fainting at home- EMS verbalized that the client was alone, and it appears that he lives alone- When arriving to the ED his serum digoxin level is 2-5 ng/mL- He is transferred to a medical telemetry nursing unit- The next day, the nurse asks the patient to tell her about his routine for taking his daily digoxin tablets- The client verbalized problems hearing the nurse- The nurse rephrased her questions- After being asked several times, he states that he was told to check his pulse every morning before taking a pill- He does this in his kitchen because the clock on the wall has big numbers and he can see the second hand go around- The nurse asks him how long he measures his pulse- He replies "I keep counting the beats until I get to 60- Sometimes it takes a longtime- Then I take my heart pill-" Later he tells the nurse that he hates "having so many pills to take" and admits having trouble remembering to take his pills- He states that he sometimes can’t remember which pills to take with breakfast and which to take at night- I sometimes take medication when I get up to use the bathroom at night-” I am really not sure which one it took, it was dark-” Insurance: Medicaid and Medicare Other Medications: Simvastatin 2omg PO daily, Lasix 2omg PO daily, Lisinopril 2omg PO daily, Tamulosin 0-4mg daily- Current Medical history: CHF Hyperlipidemia HTN Osteoarthritis COPD Past Medical History: Smoker of 25 years 01. From the history and data presented above what type of physiological changes has occurred? Described the changes- (1opt)