In the following case study, the author will discuss the issues surrounding a seventy-year-old female with a chronic neuropathic ulcer on the sole of her right foot and the rationale and implications of Furthermore, Stenner and Courtenay (2010) agree that certain drugs can induce both liver and kidney function problems to name but a few and that nurse prescribers must be aware of these potential hazards, as they are accountable for their actions as prescribers.
Red flags highlighted from obtaining the past medical history were neuropathy and raynauds disease because, in this particular scenario, it made the author aware of decreased sensation in the foot due to raynauds and the pain associated with her neuropathy when considering a differential diagnosis such as arterial disease or recurrent osteomyelitis. Culley (2005) agrees that identifying and exploring red flags is crucial and very salient with regard to a robust assessment and subsequent safe prescribing. The British National Formulary (BNF) (2010pg 24 a) indicates that the ageing process can alter the pharmacodynamics and pharmacokinetics which induce a decrease in both hepatic and renal function. These pharmacokinetic changes akin with decreased mobility will hinder how they absorb, distribute, metabolise and excrete drugs, which will result in an increase in the tissue concentration of a drug. Routine bloods were obtained by the nurse, which would confirm both liver and kidney function and what caution if any had to be taken prior to treatment options.
