The nurse is not surprised when a health care provider orders a ...

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The nurse is not surprised when a health care provider orders a lower than normal dose of a drug excreted by the kidneys for an older adult client because certain effects of aging cause the body to retain drugs and other substances for longer periods.
 
  Which normal effects of the aging process decrease the ability to excrete drugs?
  1. Decrease in renal blood flow.
  2. Decrease in the number of functioning nephrons.
  3. Decrease in the ability to excrete waste products effectively.
  4. Decrease in gastric pH, causing delayed absorption.
  5. Decrease of fat storage, causing delayed absorption.

Question 2

An older adult client complains to the nurse that a medication is causing significant nausea and vomiting. Which responses by the nurse are appropriate?
 
  1. A normal consequence of aging is decreased blood flow to the stomach. This could result in the medication staying in your stomach longer, causing nausea and vomiting.
  2. A normal consequence of aging is slowed emptying of stomach contents. This can cause nausea and vomiting.
  3. A normal consequence of aging is slower absorption of medications, resulting in nausea and vomiting.
  4. A normal consequence of aging is an increase in liver size, which can result in nausea and vomiting.
  5. A normal consequence of aging is decreased carbohydrate metabolism, which can result in nausea and vomiting.

[ultraflyy23]

Answer to Question 1

Correct Answer: 1,2,3
Rationale 1: Older adults have a decrease in blood flow to kidneys. This may affect excretion of drugs.
Rationale 2: Older adults have a decreased number of nephrons resulting in a decreased number of functioning nephrons. This may affect excretion of drugs.
Rationale 3: Because of age-related changes to the kidneys, the older adult may have difficulty excreting waste products, which may affect excretion of drugs.
Rationale 4: Delayed absorption does not affect the excretion of drugs.
Rationale 5: The elderly have an increase in fat storage, but that does not affect the excretion of drugs.
Global Rationale: Older adults have a decrease in blood flow to kidneys, a decreased number of nephrons resulting in a decreased number of functioning nephrons, and may have difficulty excreting waste products. All of these factors may affect excretion of drugs. Delayed absorption does not affect the excretion of drugs. The elderly have an increase in fat storage, but that does not affect the excretion of drugs.

Answer to Question 2

Correct Answer: 1,2,3
Rationale 1: Decreased blood flow to and from the stomach may delay absorption, resulting in nausea and vomiting.
Rationale 2: Slowed emptying of stomach contents may allow drugs to remain longer in the gastrointestinal tract, resulting in nausea and vomiting.
Rationale 3: When absorption time is decreased, drugs may remain longer in the stomach, resulting in nausea and vomiting.
Rationale 4: The size of the liver does not cause risk for nausea or vomiting.
Rationale 5: Carbohydrate metabolism does not cause risk for nausea or vomiting.
Global Rationale: Decreased blood flow to and from the stomach may delay absorption, resulting in nausea and vomiting. Slowed emptying of stomach contents may allow drugs to remain longer in the gastrointestinal tract, resulting in nausea and vomiting. When absorption time is decreased, drugs may remain longer in the stomach, resulting in nausea and vomiting. The size of the liver does not cause risk for nausea or vomiting. Carbohydrate metabolism does not cause risk for nausea or vomiting.

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