When completing medication reconciliation for an older woman, the ...

[D2AR0N]

When completing medication reconciliation for an older woman, the nurse notes that the patient is being discharged home on anticoagulant therapy. The nurse also notes that at admission, the patient reported that she uses herbal supplements at home.
 
  Which instruction should the nurse include during discharge teaching? a. You may need to supplement with only ginkgo while on anticoagulant therapy.
  b. You may need to increase the use of gar-lic supplements while on anticoagulant therapy.
  c. Avoid using Hawthorn supplements while taking an anticoagulant medication.
  d. Avoid using chamomile supplements while on anticoagulant therapy.

Question 2

Which is a true statement?
 
  a. Urine flow gradually decreases in old age.
  b. Elders generally need less fluid than younger people because of their lower body water content.
  c. Urine specific gravity and skin turgor can be used to diagnose dehydration in elders and in younger people.
  d. Multiple physiological changes of aging place elders at greater risk of dehydration than middle-aged persons or children.

[Liddy]

Answer to Question 1

D
The nurse's priority is to stop this older adult's intake of chamomile supplements at home; they will increase the effectiveness of anticoagulation. The nurse instructs this individual to avoid chamomile while she is taking an anticoagulant because the woman's blood will be much less able to clot, exposing her to a very high risk of a catastrophic injury in the event of a fall or trauma. The patient does not need to supplement with only ginkgo; the patient should cease taking ginkgo while on anticoagulant therapy, as well as the use of garlic supplements. Both increase the effectiveness of anticoagulation. The use of Hawthorn supplements has not been shown to affect the use of anticoagulant medications.

Answer to Question 2

D

Feedback
A Incorrect. Urine flow does not diminish in old age. Specifically, it does not di-minish in the presence of dehydration as it does in a younger patient.
B Incorrect. Lower body water content puts an older patient at greater risk of de-hydration, not less.
C Incorrect. These signs are less reliable in old age because of changes to the tis-sues.
D Correct. Loss of water-containing tissues, loss of concentrating power in the kidney, and decreased sense of thirst all increase an older person's risk for de-hydration.

[D2AR0N]

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