Pharmacology: Chapter 5
Polypharmacy
Use of several drugs during the same period.
The ability of older adults to adequately distribute drugs that are ingested is highly dependent on serum levels of what factor?
Albumin
To reduce an older adult's risk of experiencing adverse drug effects or interactions, what action should the nurse PRIORITIZE?
Assess the client's use of herbal remedies and over-the-counter (OTC) medications.
A 78-year-old client intends to supplement a prescribed anti-inflammatory with a herbal remedy that a neighbor strongly recommended. What action should the nurse encourage the client to take before initiating that plan?
Checking with the care provider before taking the supplement.
A 68 year old woman is receiving chemotherapy. What is the rationale for teaching her to drink eight glasses of water throughout the day following the administration of chemotherapy?
Chemotherapy is excreted in the kidneys and urine. The water will help eliminate it from the body.
The nurse should caution an older adult against using diphenhydramine hydrochloride due to what increased risk?
Confusion
What phenomenon is primarily responsible for the changes in pharmacokinetics that accompany the aging process?
Decreased function of vital organs.
What factors contribute to the decrease in absorption that accompanies aging? Select all that apply.
Decreased gastric emptying; Decreased blood flow in the GI tract; Decreased surface area of the GI tract.
A 68 year old woman has been prescribed digoxin (Lanoxin) 0.125 mg. Based on her age, what condition is she at risk for developing?
Digoxin toxiciy
How can the nurse BEST work with the care team to prevent polypharmacy-related issues for older adult clients prescribed multiple medications?
Ensure that each of the client's medications is genuinely necessary and discontinue those that are not.
When conducting health promotion education with older adults, what intervention should the nurse encourage to help reduce their risks of altered drug responses?
Frequent physical activity
A 78 year old man is receiving treatment for hypertension. He has been having persistent headaches and difficulty with the medications he has been prescribed. This is the third prescription he has received. He states, "I cant afford to get this filled and then stop it in a few days." Which statement is most appropriate for the nurse to communicate to the patient?
Have the pharmacist give you a few pills to start.
Ethnicity is a variable that is known to affect what aspect of pharmacokinetics in older adults?
Metabolism
An older adult client has presented with signs and symptoms that are suggestive of a urinary tract infection. Due to the risk of nephrotoxicity among older clients, the nurse practitioner should avoid prescribing which drug?
Nitrofurantoin
Age-related changes
Physiologic events due to increasing age, which affect drug responses.
Risk-to-benefit ratio
Poor outcome [adverse effects of medications] in relation to good outcome [desired medication effects]; increases with increasing age.
A 75-year old woman is having difficulty remembering to take all of her medications. Which of the following nursing interventions will assist her to improve adherence to the medication schedule?
Provide a medication administration aid.
An older adult client prescribed a diuretic has had two falls in the period of a week. The care provider's willingness to discuss discontinuation of the medication demonstrates a consideration of what safety-related action?
Risk-to-benefit ratio
An 85 year old woman is administered a general anesthetic for repair of a hip fracture. Which of the following properties of the anesthetic place her at risk for respiratory depression?
Solubility in lipids
The client's admission blood work indicates a low creatinine clearance rate (CrCl). This factor may have what implication for the older client's antibiotic-related pharmacotherapy?
The client may require lower-than-normal dosages of a drug.
When administering a beta-adrenergic agonist to a patient older than 65 years of age, what response do you anticipate?
The dosage will need to be increased to provide an effective response.