NP student needing help with case study

Hi, thanks for getting back to me!

The case scenario is as follows:

Mrs. bryan is a 88 year old recently widowed female. She lives alone in elderly housing with her 3 dogs. Her husband recently died at home from Alzheimer's Disease. She has been independent in all aspects of her life. She does her best to keep up with the housework but her family describes her apartment as somewhat "cluttered". The family has offered to pay someone to come in to help but she has refused, stating she "does not want strangers in her home". She has a history of diabetes and reports poor vision and burning in her feet. She also complains of not being able to sleep and tells you she "can't sleep without taking Ativan". She has not been able to go to the doctor for over a year with her husband being sick. Mrs. Regis has fallen several times in her apartment since her husband has died. Her daughter is fearful she will "break something" given all of the falls. She comes to the clinic today with her daughter for a comprehensive geriatric examination. Patient's main concern for you is that she get a refill for her Ativan. Daughter's main concern is if her mother should be driving?

Medications:

Lisinopril 5mg po qd

Ativan 0.5mgpo qhs

Atorvastatin 80mg po qd

Levoxyl 25mcg qg

Lantus 15units qd

Neurontin 300mg po tid

HCTZ 25mg po qam

EC ASA 325mg po qd

Im having trouble with primary and secondary prevention measures: primary i have... smoke cessation and certain exercise programs given per potential risk for PVD.

Well...not pvd but diabetes! Her daughter is concerned about driving but her failing eyesight and burning in feet are secondary to the poorly managed diabetes.

What is contributing to her fall risk? Think diagnosis, symptoms, medications.

Disclaimer: I am not an NP yet, but I have taken advanced health assessment, advanced pharm and advanced patho.

Why does she have 2 different names? (Mrs. Bryan and Mrs. Regis)

Also, the case study doesn't mention smoking so smoking cessation wouldn't make sense.

Primary Prevention measures are those aimed at preventing adverse health conditions. Think about what are the health conditions this patient doesn't have but is at risk for and how you could help prevent them from developing.

Secondary Prevention measures are screening to detect problems early. Screening guidelines are a good place to start.

This lady also has MULTIPLE fall risks that you have listed.... I'm sure you are familiar with the BEERS list as well??