An older adult, aged 72, with type 2 diabetes and coronary artery ...

[dakota nelson]

An older adult, aged 72, with type 2 diabetes and coronary artery disease is admitted to a long-term care facility. The client takes glipizide (Glucotrol) and isosorbide mononitrate (Imdur).
 
  The medical history states that the client drank 4 ounces of whiskey per day for many years. Which of the following actions should be a priority for the admitting nurse?
 
  A) Assess and observe for depression.
  B) Assess for hypoglycemia and hypotension.
  C) Evaluate the client for renal failure.
  D) Evaluate blood work for changes in electrolytes.

Question 2

A healthy 70-year-old has been using diphenhydramine (Benadryl) for allergic rhinitis. One week later, the client begins to exhibit signs of confusion and disorientation. The spouse calls the primary care facility to speak with the nurse.
 
  Which event should the nurse suspect first?
 
  A) The older adult has hyponatremia, leading to delirium.
  B) The older adult is having transient ischemic attacks.
  C) The older adult has an overwhelming infection.
  D) The older adult is experiencing an adverse drug effect.

[Jmfn03]

Answer to Question 1

Ans: B
Older adults are more susceptible to developing medicationalcohol interactions. Age-related changes in body composition can cause higher levels of alcohol to be absorbed into the bloodstream. Alcohol enhances vasodilation when an individual takes a nitrate, and there is potentiation of oral hypoglycemics by alcohol. CNS depression occurs when alcohol interacts with barbiturates and meprobamate, which this client is not taking. There is no need to evaluate for renal failure or changes in electrolytes; these are not known medicationalcohol interactions.

Answer to Question 2

Ans: D
The older adult has been taking diphenhydramine, which can have an anticholinergic effect. Anticholinergic drugs can lead to medication-induced cognitive impairment. There is no reason to think that the client has hyponatremia. Rhinitis does not generally cause delirium in older adults. The client is more likely to be having adverse reaction than transient ischemic attacks.