An older patient drinks a six-pack of beer daily. The patient ...

[crazycityslicker]

An older patient drinks a six-pack of beer daily. The patient tells the community health nurse, I've been having trouble with my arthritis lately, so I take acetaminophen four times a day for pain. What are the nurse's priority interventions?
 
  Select all that apply.
 
  a. Inquiring about sleep disturbances caused by mixing alcohol and analgesic medications
  b. Determining the safety of the daily acetaminophen dose the patient is ingesting
  c. Advising the patient of the harmful effects of alcohol and acetaminophen on the liver
  d. Suggesting an increase in the acetaminophen dose because alcohol causes faster excretion
  e. Assessing the patient for declining functional status associated with medication-induced dementia

Question 2

A nurse assessing an older adult patient for suicide potential should include questions about mood and which other symptoms? Select all that apply.
 
  a. Increased appetite
  b. Sleep pattern changes
  c. Anhedonia and anergia
  d. Increased social isolation
  e. Increased concern with bodily functions

[katkat_flores]

Answer to Question 1

ANS: B, C
The nurse should be concerned with the patient's use of alcohol and acetaminophen because the toxicity of acetaminophen is enhanced by alcohol and by the age-related decrease in clearance. The nurse must determine whether the acetaminophen dose is within safe limits or is excessive and provide this information to the patient. Next, the nurse must provide health education regarding the danger of combined use of acetaminophen and alcohol. The patient will need to discontinue or reduce alcohol intake. Another analgesic with less hepatotoxicity could be used. Additional acetaminophen would cause greater liver damage. The scenario does not suggest dementia.

Answer to Question 2

ANS: B, C, D, E
These symptoms are often noted in older adult patients with depression. Somatic symptoms are often present but are missed by nurses as being related to depression. Anorexia, rather than hyperphagia, is observed in major depression. Low self-esteem is more often associated with major depression.

[crazycityslicker]

Gracias!

[sultansheikh]

TYSM