Answer to Question 1
D
Canes can relieve stress on arthritic joints on one side. A walker can equally relieve pressure on joints on both sides. Cane tips should be flat on the bottom with a series of rings, not smooth. Older adults are tempted to save money by using assistive devices from nonmedical sources; however, regardless of the source of the assistive device, the device should be fitted to the older adult. An older adult should never try to adapt to the assistive device; an ill-fitted device can contribute to falls and injuries. Using a walker is contraindicated when climbing stairs. Impro-perly selected or improperly used assistive devices can be risk factors for falling.
Answer to Question 2
A
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A Correct. Morphine sulfate 2.5 mg IV every 2 hours PRN is a suitable dosage for an adult who weighs 68 kg because this medication, when administered by IV route, peaks in 20 minutes and has a half-life of 1.5 to 2 hours. The action of this medication peaks very quickly and thereafter begins to diminish, providing a great deal of control for the nurse. After 2 hours, the nurse can administer addi-tional morphine but must remember that, potentially, 1.25 mg of active morphine continues to circulate in this individual's blood stream.
B Incorrect. Five mg of morphine every 2 hours subcutaneously is an excessive dose for an older adult because morphine administered in this manner peaks in action at 20 minutes, and a 5-mg dose can be sufficient to cause respiratory de-pression. In addition, because the half-life is 1.5 to 2 hours, 2.5 mg of morphine can still be present in the circulation when it is time for the next dose.
C Incorrect. Oxy-Contin, an extended-release form of Oxycodone, has a peak ac-tion of 1 hour and a half-life of 3-5 hours. Twenty milligrams is an excessive dose for an older adult weighing 68 kg because it can induce respiratory depres-sion at its peak, and 4 hours after administration, 10 milligrams of medication can remain active. Oxy-Contin is also more likely to cause hallucinations and delirium in an older adult than morphine sulfate.
D Incorrect. A dosage of 0.5 mg is unlikely to be therapeutic.
Common drainage devices; A.Penrose Drain; B. Hemovac;
Treating the older adult
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Approximately 40 percent of farmers in the United States are 55 years old or older