Which questions would the case manager ask the older adult client ...

[future617RT]

Which questions would the case manager ask the older adult client to assess for risk for nonadherence to a medication regimen?
 
  1. How do you feel about the possible side effects your medication may cause?
  2. If we set you up with a pill holder, do you think you will be able to remember to take the medication?
  3. I have put large labels on the bottles; can you see the print?
  4. Do you feel you can afford the cost of the medication after your insurance pays its part?
  5. Can your daughter visit every day to give you the medication?

Question 2

The nurse is caring for an older adult client prescribed acetaminophen (Tylenol), as needed, for frequent headaches. What can the nurse expect?
 
  1. The client may not ask for the medication as often as younger clients.
  2. This drug may be prescribed with longer interval dosing.
  3. The health care provider may order a lower than normal dose.
  4. The health care provider will order diagnostic lab work to check creatinine clearance.
  5. The health care provider will need to prescribe nausea medication.

[lindahyatt42]

Answer to Question 1

Correct Answer: 1,2,3,4
Rationale 1: Unpleasant side effects increase risk for nonadherence.
Rationale 2: Forgetfulness is a cause for nonadherence.
Rationale 3: Physical impairment such as poor vision can lead to nonadherence.
Rationale 4: Inability to purchase is a risk for nonadherence.
Rationale 5: This question assumes that the client is unable to self-administer the medication, which is not the same as assessing the older client's ability to adhere to the medication regimen.
Global Rationale: Unpleasant side effects, forgetfulness, physical impairment, and the inability to purchase all increase the risk for nonadherence. Asking the client if a daughter can visit every day to administer a medication assumes that the client is unable to self-administer the medication, which is not the same as assessing the older client's ability to adhere to the medication regimen.

Answer to Question 2

Correct Answer: 1,2,3
Rationale 1: Reduced metabolism will result in extended duration of the drug.
Rationale 2: Acetaminophen (Tylenol) has a long half-life and remains in tissues longer, resulting in toxicity. The health care provider may prescribe longer dosing intervals.
Rationale 3: Acetaminophen (Tylenol) has a long half-life and remains in tissues longer resulting in toxicity. The health care provider may prescribe a lower dose.
Rationale 4: Creatinine clearance tests kidney function, not hepatic function.
Rationale 5: Acetaminophen (Tylenol) does not cause nausea.
Global Rationale: Reduced metabolism will result in extended duration of the drug; therefore, the client may ask for the medication less frequently. Acetaminophen (Tylenol) has a long half-life and remains in tissues longer, resulting in toxicity. The health care provider may prescribe longer dosing intervals and at lower dosages. Creatinine clearance tests kidney function, not hepatic function. Acetaminophen (Tylenol) does not cause nausea.

[future617RT]

Excellent

[Sarahjh]

TYSM