What are some potential barriers that Mary may have to adhere to her home medication therapy?

Mary has an IV solution of normal saline infusing in her left arm and oxygen by mask at 2 L/min. Last week she heard that her older cousin had passed away, and since then she has become extremely depressed. She refuses to eat or drink but continues to take her medications on a regular basis. This 80-year-old woman is dehydrated and somewhat confused. Her neighbor provides the history. The nurse finds that Mary has been taking a diuretic (hydrochlorothiazide), an antihypertensive (atenolol), and multivitamins daily.
Vital signs are as follows: temperature = 38.6 C (101.4 F); apical pulse = 100 beats/min; respiratory rate = 32 breaths/min; and blood pressure 92/62 mmHg. Her skin is dry and warm to the touch, and her lips are pale, dry and chapped. She weighs 51.3 Kg (113 lbs) and her height is 1.7 m (5’7″). Her speech is quiet and slurred. Mary has not eaten anything during the past 24 hours and has only taken sips of water during the past 12 hours. She has voided once in 12 hours.
The following laboratory tests are completed: urinalysis, blood urea nitrogen (BUN) and creatinine, complete blood count (CBC), and basal metabolic panel (BMP). Mary is prescribed IV rehydration fluid and is stabilized in the emergency department before being admitted to the hospital unit.
This activity contains 5 questions:
What are some potential predisposing physiologic changes that Mary is experiencing with age that could lead to her condition?
What are some potential barriers that Mary may have to adhere to her home medication therapy?
What adverse drug reactions are you seeing that would be more common in an older adult?
What are the most immediate patient care priorities for the nurse to address at this time?
What priority areas will the nurse assess?

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