The nurse admits an older adult client and reviews orders from ...

[tichca]

The nurse admits an older adult client and reviews orders from the physician.
 
  What order would the nurse question?
   Bedrest with bathroom privileges
   Acetaminophen (Tylenol) 650 mg p.o. every 4 hours p.r.n. pain
   Meperidine (Demerol) 100 mg IM every 6 hours p.r.n. pain
   Zolpidem tartrate (Ambien) 5 mg p.o. p.r.n. HS
  1. Bedrest
  2. Acetaminophen
  3. Meperidine
  4. Zolpidem tartrate

Question 2

The nurse admits an elderly client to the physician's office and learns the client has been seeing a cardiologist, nephrologist, hematologist, and pulmonologist for differing medical diagnoses.
 
  When collecting data on this client, the nurse carefully questions: 1. Current diagnoses.
  2. Results of recent laboratory findings.
  3. Current symptoms.
  4. Current medications.

[Kedrick2014]

Answer to Question 1

3
Rationale: The dosage of meperidine is at the upper limit for a healthy younger adult, but is a very high dosage for an elderly client, and the nurse should question the order. The other orders are appropriate for the older adult.

Answer to Question 2

4
Rationale: The client who is under the care of multiple providers risks polypharmacy, and the nurse must carefully assess the client's current medications. Another concern for this client is that one provider might order a drug that interacts with another prescribed medication due to inaccurate understanding of all of the client's medications.