Chapter 7 Flashcards
Geriatrics (18 cards)
What 6 factors influence absorption in geriatric patients?
- Decreased GI surface area
- Decreased gastric emptying
- Decreased gastric blood flow
- Decreased gastric acid production
-Difficulty swallowing - Poor nutrition
What factors influence geriatric distribution?
- Increased body fat
- Decreased lean body mass and total water
- Decreased albumin
What does increased body fat in geriatric patients do in regards to absorption?
Some lipid soluble drugs will be stored here and their plasma level will then be decreased.
How does decreased lean body mass and total water influence absorption in geriatric patients?
Water soluble drugs become distributed in smaller volumes, causing an increase in concentration of the drug.
What does decreased albumin influence in geriatric patients?
Free drug levels may rise.
What happens to drug metabolism in geriatric patients?
The rate of metabolism is decreased.
Why is the rate of metabolism decreased?
- Decreased blood flow
- Smaller liver size
- Decreased acitivity of certain liver enzymes
What is the result of decreased metabolism rate in geriatric patients?
Drug half-lives may be increased, therefore prolonging responses
What is the MOST important cause of adverse drug reaction in the elderly?
Drug accumulation secondary to reduced renal excretion
What should be monitored to distinguish renal function?
Creatinine
What should the nurse encourage when teaching an elderly client?
Encourage simple dosing schedule
What two factors are common potential nursing diagnoses?
- Ineffective health maintenance related to lack of transportation
- Nonadherence related to lack of insurance
What two processes take place in the planning phase of the nursing process?
- The older adult will take the prescibed medications as ordered
- The drug therapy will be effective with no or few side effects
What is the appropriate nursing intervention in the nursing process of drug administration in elderly adults?
- Monitor laboratory results
What does grapefruit juice do to the metabolism of drugs?
Inhibits the metabolism of certain drugs therefore increasing drug levels. It does this by inhibiting the CYP3A4 (liver and intestinal isoenzymes)
The nurse is aware that the physiologic changes of
aging that can affect drug activity include all of the
following except:
A. increased fat-to-water ratio
B. decreased liver enzyme production
C. loss of nephrons
D. increased gastrointestinal blood flow
D. increased gastrointestinal blood flow
Rationale: Older adults have decreased
gastric acidity, reduced peristalsis,
decreased body water, increased fat-to water
ratio, decreased numbers of functioning
nephrons, and decreased liver enzyme
production and function.
The nurse is aware that adverse reactions and drug
interactions occur frequently in older adults due to all
of the following except
A. consumption of numerous drugs owing to multiple
chronic illnesses
B. drugs ordered by several health care providers
C. increased incidence of allergic responses
D. self-medication with OTC preparations
C. increased incidence of allergic responses
Rationale: The immune system of the older
adult decreases rather than increases in
allergic responses. It is common for older
adults to take many drugs together.
Polypharmacy is due to multiple health care
providers ordering many medications for
older adults. Older adults are prone to self-
medicate with OTC preparations.
Which organs are important in drug
therapy of the older client and should be
monitored?
a. Kidney and pancreas
b. Kidney and liver
c. Liver and pancreas
d. Kidney and lungs
B – Kidney and Liver
