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Caring for the Older Adult at Risk for Falling

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Mrs. Smith is a 72-year-old woman residing in an assisted living facility who complains of intermittent, daily episodes of dizziness, usually while arising from bed. The episodes last several hours and diminish in the early afternoon. She notes that the room spins and the feeling is exacerbated by turning her head. Past medical history is significant for myocardial infarction, mild heart failure, atrial fibrillation, and hypothyroidism. Medications include atenolol 100 mg daily, verapamil 180 mg daily, furosemide 20 mg daily, levothyroxine 0.1 mg daily, coumadin 5 mg daily, and docusate 100 mg daily. She told her doctor about the dizziness, and was prescribed meclizine 25 mg 3 times a day as needed, with only minor relief. Mrs. Smith takes her meals in the dining room but often skips breakfast for fear of falling on her way. She is worried about going to her niece's home for a family party next week.  The nurses working with Mrs. Smith have implemented strict falls precautions due to her dizziness and have set rules around when she can leave her room as well as when she can walk.  Mrs. Smith is anxious and fearful and is concerned about her quality of life. 

Adapted from Comprehensive Management of Dizziness in Elderly Clients by Sandra M. Nettina, MSN, RN, CS, ANP. Retrieved from Topics in Advanced Practice Nursing eJournal. 2001;1(1) Full article can be accessed at

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