The nurse is caring for a 78-year-old patient who lives ...

[Ebrown]

The nurse is caring for a 78-year-old patient who lives independently. The patient will begin a new drug regimen that requires taking multiple drugs at various times per day. Which intervention is appropriate for the nurse to implement with this patient?
 
  a. Ask the patient's family members to monitor the patient's drug regimen.
  b. Develop a log to record the times each drug will be taken.
  c. Reinforce the need to take the drugs as scheduled.
  d. Write the medication administration times on each prescription label.

Question 2

Which drug properties are problematic for older patients? (Select all that apply.)
 
  a. Drugs with anticholinergic effects
  b. Drugs that are highly protein-bound
  c. Drugs with a short half-life
  d. Drugs that undergo hepatic conjugation
  e. Drugs with a narrow therapeutic range

[jaykayy05]

Answer to Question 1

ANS: B
The patient should be advised to keep a medication record of drugs and when they will be taken. The patient is independent, and this helps maintain independence. Family member support is essential when older patients are confused. Reinforcing information without providing a means to keep track of the medications does not necessarily improve compliance. Writing medication times on prescription labels does not help to organize the medication schedule.

Answer to Question 2

ANS: A, B, E
Older patients are more susceptible to drug side effects, especially those that cause anticholinergic effects. Older patients have a loss of protein-binder sites for drugs, so those that are highly protein-bound will have higher than usual serum levels and can cause toxicity. Drugs with a narrow therapeutic range require closer monitoring in all patients, but especially in older patients. Drugs with a short half-life are preferred because older patients have a decreased ability to metabolize and excrete drugs. Hepatic conjugation is usually not influenced by older age, liver diseases, or drug interaction.

[Ebrown]

Excellent

[debra928]

TYSM