Medication Non-compliance

[jlynn3324]

I have a patient that has CHF and was recently in hospital for CHF exacerbation and pneumonia. While in hosptial she had a Thoracentesis. I received a call from her sister today who wanted to know why this patient was on so many medications (Lasix, Aldactone, Coreg, Lanoxin, Potassium, etc). I tried to explain all medications, what they do and the importance of taking daily as ordered. The sister stated she used to be a nurse and patient was taking too many medications. Sister stated she told patient not to take medications today. The patient has a little confusion but is fairly competent. I tried again to educate on importance of taking these medications to prevent exacerbations but this did not help. I finally told sister to make an apt with MD to discuss the medications.This patient has been non-compliance in the past and on many occasions the nurse has noted +3 edema to bilateral ankles and crackles in lung fields. I informed the MD of my conversation with the sister and nurse stated she would make note and inform MD. I also told nurse that sister will be calling to make apt. I tried calling this patient's daughter but no answer. What else can I do? A nurse is going back out tomorrow to talk to the patient face to face. I have also given patient written info about medications. Any sugestions? :banghead:

[caliotter3]

Make certain that you keep in contact with the MD, the nursing supervisor, and that everything is properly documented. Whether intentional or not, the relative is setting you and the patient up for problems. Would be nice if the doctor took the initiative in dealing with her but that is probably asking for too much. Every time the subject comes up, I would refer her to the MD and document.