Medication Reconciliation Assignment

a.  Explain the medication reconciliation processb.  Analyze the client scenario for any omissions, additions, or duplications of medications and discuss the implications to the client.c.  Analyze the client scenario for potential risks associated with the client’s current condition and currently prescribed home medicationsd.  Identify potential drug interaction and prioritize the drug interactions that are most concerning to you.e.  Identify actions that the nurse should implement and provide a reason for each action.1.  Mr. H. is being admitted with a broken hip due to falling at home and will be having surgery the next morning.  Past medical history includes hypertension and Type 2 diabetes. Allergies: Penicillin.  The home medication list is provided to the nurse and includes the following medications:a.  Metoprolol 25 mg PO dailyb.  Atenolol 50 mg PO dailyc.  Garlic 1000 mg PO dailyd.  Metformin 500 mg PO twice dailye.  Aspirin 81 mg PO daily2.  The admitting orders include the following medication orders:a.  Continue all home medications except metforminb.  Insulin subcutaneous based on sliding scale Bi.  Blood sugar <150= 0 unitsii.  Blood sugar 151-175= 2 unitsiii.  Blood sugar 176-200=3 unitsiv.  Blood sugar 201-225=4 unitsv.  Blood sugar 226-250=5 unitsvi.  Blood sugar 251-300= 6 unitesvii.  Blood sugar > 300= notify healthcare providerc.  Enoxaparin 40 mg subcutaneous daily, first dose tomorrow following surgeryd.  Piperacillin/tazobactam 3 gram/0.375 gram IV every 6 hours, first dose 30 minutes prior to surgery