Exam 2: NUR257/ NUR 257 (New 2024/ 2025 Update) Aging and Chronic Illness in Nursing Review |Questions and Verified Answers| 100% Correct| A Grade -
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QUESTION
Polypharmacy is MOST accurately defined as
Answer:
the prescribing of multiple drugs to treat the same condition... could be multiple conditions being treated as well.
• Five or more medications
• Multiple medication for the same problem
• Increased risk for drug interactions
• Increased risk for adverse events
• Can result from fragmented communication (in healthcare providers: Pt sees their primary HCP, then the cardiologist, then the respiratory specialist, endocrinologist etc.)
QUESTION
Metabolism (biotransformation)
Answer:
The process by which the body modifies the chemical structure of the drug.
Liver
Elderly considerations:
Reduced hepatic activity, Mass, Volume and Blood flow to liver
Hepatic Clearance - medication is ¯ by 30-40%
QUESTION
Excretion
Answer:
Drugs and their metabolites are excreted in sweat, saliva, and other secretions but their primary site of excretion is through the kidneys.
Elderly considerations:
Significant decline in kidney function Decreased glomerular filtration rate Decreased creatine clearance
QUESTION
Pharmacodynamics
Answer:
The interaction between a drug and the body. The older the person gets, the more likely there will be an altered or unreliable response of the body to the drug
Elderly considerations:
Decreased response to beta-adrenergic receptor stimulators and blockers
Decreased baroreceptor sensitivity
Increased sensitivity to a number of medications: anticholinergics, benzodi- azepines, narcotic analgesics, warfarin, and the cardiac drugs diltiazem and ver- apamil.
QUESTION
Chronopharmacology
Answer:
the study of how the timing of drug administration influ- ences a drug's response
many drugs are administered at a time of day that corresponds to a biological rhythm
• The relationship between the biological rhythms of the body and variations in the pharmacokinetics and pharmacodynamics.
• Example: if a cortisone tablet is taken in the early morning, it may have little or no effect on the adrenocortical system.
QUESTION
Drug-Drug Interactions (DDIs)
Answer:
when one drug affects the way another drug acts on the body.
• ACE inhibitors and potassium-sparing diuretics - this will increase potassium levels in the body
• ACE inhibitors or ARBs and Septra (Bactrim) - Increased Potassium in body
• Macrolide antibiotic (e.g., Cipro) and either calcium channel blockers or digoxin - may lead to hypotension
• Warfarin and any of the antibiotics or NSAIDs - This is a big anticoagulant affect, thins the blood
QUESTION
Examples of medications that can easily impair cognitive function in older adults
Answer:
• Analgesics
• Those with anticholinergics properties
• Antihistamines
• Benzodiazepines
• Antiparkinsonian medications
• Beta blockers
• Lanoxin
QUESTION
Beers Criteria
Answer:
Beers Criteria List - result of an exhaustive analysis of medica- tion frequently prescribed to older adults.
o Potentially inappropriate for use with all older adults
o Potentially inappropriate for older adults with certain conditions o Should only be used with caution
o Should be avoided or have their dose changed for people with impaired renal function
o Are on a list of drug-drug interaction documented to be especially harmful to older adults
QUESTION
Most common inappropriate medication for elderly to take
Answer:
NSAIDS
QUESTION
Neuromalignant Syndrome (NMS)
Answer:
NMS - a rare but potentially life-threatening
ADE to anti-psychotics
o Most typical physical cues are temperature greater than 100.4°F, muscle rigidity, autonomic instability (e.g., labile blood pressure, tachycardia) and altered mental status.
o Onset is rapid and unless treated appropriately death can occur quickly
o Drug most associated with NMS is haloperidol (Haldol) but is also has developed when a person is taking chlorpromazine (Compazine) and promethazine (Phener- gan) used for nausea.
o It occurs most often in the first 2 weeks of the start of treatment but also be considered whenever a dose is increased
o NMS may also be seen if anti-Parkinson's medications are stopped abruptly.
- excessive dopamine blockade
- increased muscle tone
QUESTION
SAFEDRIVE
Answer:
Assessment should include evaluation of whether an individual can drive, feels safe driving, and has a driver's license
• There is no gold standard for determining driving competency
• Driving evaluations are offered by various community agencies - should be done every 6 months
• Dementia can impair cognitive and functional skill required for safe driving
• S - safety record [Show Less]