Chapter 8- Life Span- Older Adults
1. A nurse who is working with an older adult patient who takes eight medications a day wants to promote medication
... [Show More] adherence. Which of the following nursing interventions would best promote medication adherence?
A) Take prescribed medication as needed.
B) Refill prescription medication when the last dose is taken.
C) Place pills in a daily or weekly pillbox organized according to hours of the day or mealtimes.
D) Ask for child-proof caps for all medication bottles. Ans: C
Feedback:
Placing pills in a daily or weekly pillbox will help remind the patient to take the pills as scheduled and should serve as a visual aid to help make him more aware of having to take medication. Patients should always take medications as prescribed to ensure therapeutic effects, and prescriptions should be refilled prior to the last dose to ensure continuity of drug therapy. Elderly patients should ask for bottles with easy open caps due to possible arthritic changes that might interfere with the patient opening a bottle.
2. A nurse is administering drugs to a 70-year-old patient who has a reduced plasma albumin level. When assessing the patient for therapeutic outcomes of drug therapy, the nurse will also be careful to observe for
A) possible drug toxicity.
B) decreased therapeutic effects.
C) altered drug absorption.
D) increased drug metabolism. Ans: A
Feedback:
Decreased levels of plasma albumin can lead to fewer binding sites for protein-binding drug molecules. Decreased binding sites results in higher concentrations of unbound forms of a drug, which increases the risk of adverse effects and toxicity and can increase therapeutic effects. Plasma albumin does not alter absorption of a drug but is responsible for binding, transporting, and distributing drugs throughout the body. Even though higher concentrations of a free drug increase the amount of the drug available for metabolism, normal age-related decreases in liver function offset any increase in the pharmacokinetic process.
3. A 72-year-old man who is unable to sleep since admission into the hospital is given a hypnotic medication at 9 PM. The nurse finds the patient drowsy and confused at 10 AM the next day. The nurse is aware that this behavior is most likely due to
A) decreased hepatic function.
B) a toxic effect.
C) an allergic reaction.
D) increased renal function. Ans: A
Feedback:
Decreased hepatic function may extend the half-life of a drug and increase the patient's response to the drug. Increased renal function would rid the body of the drug faster than normal and would not cause prolonged effects. A toxic effect would be a more serious effect such as inability to awaken the patient. An allergic reaction does not usually manifest itself as a confused and drowsy state.
4. A nurse is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term?
A) Taking more than one drug when the patient deems it necessary
B) Taking several drugs simultaneously
C) Increasing the dosage of a drug by the patient
D) Taking one drug one day and another drug the next day Ans: B
Feedback:
Polypharmacy is defined as taking several drugs at the same time. The other options are false statements.
5. A nurse is caring for a 73-year-old man who is receiving drug therapy. He is beginning to exhibit signs of decline in his renal system, yet his current serum creatinine level is normal. The nurse will base the patient's plan of care on the understanding that there is
A) an increase in drug excretion.
B) a decrease in the effectiveness of the prescribed drugs.
C) an increase in the production of creatinine.
D) a decrease in the amount of creatinine to be filtered. Ans: D
Feedback:
The patient's creatinine level is within the normal range for his age. Less creatinine overall exists in the older adult because creatinine production declines as muscle mass decreases. The normal creatinine level can be misleading and should not be interpreted as an indication of normal renal function or effectiveness of the drug. [Show Less]