Final answer:
The nurse’s first intervention should be to review and verify all medications with the older male client who has diabetes mellitus, chronic gout, and osteoarthritis. It’s important to manage potential drug interactions and verify that he is adhering to his prescribed regimen, taking into account his medical history and the potential for impaired wound healing due to diabetes.
Step-by-step explanation:
When an older male client with a history of diabetes mellitus, chronic gout, and osteoarthritis comes into the clinic with a bag of medication bottles, the first intervention the nurse should implement is to review and verify all current medications with the client. This is essential for managing his complex health needs and avoiding potential drug-related complications. It's particularly crucial to understand how his medications may interact, given that he might be taking drugs like uricosuric drugs for gout, which increase the excretion of uric acid, or other medications that could affect his blood sugar levels.
Since the patient has multiple chronic conditions, it's vital to ensure that his prescriptions are up-to-date and that he’s taking medications as prescribed. For example, in case of any wounds or infections as experienced by Mark in the provided scenario, the patient's diabetes management plan must be reassessed because diabetes can impair wound healing due to reduced circulation and immune response. If the patient shows any signs of infection, like fever or redness and swelling, it is crucial to address these immediately. Identifying signs of possible drug interactions or adverse effects is also important. For instance, the client's complaint of joint pain and weakness could indicate an issue with gout management; hence, assessing symptom severity and impact on daily activities is essential.
The Medicare prescription benefits play a vital role in regard to patients like Robert, who have chronic conditions that often require multiple medications. The nurse should be aware of any potential impact on the cost of prescriptions and work with the interdisciplinary team to provide the most effective and efficient care management. Additionally, education about the proper use of medications, including adherence to the prescribed regime and strategies to manage side effects, is a key part of patient teaching.