care of adults and geriatric patients Flashcards
describe aging
a natural process that begins at birth
when do age related changes begin
adult years (19-65)
who are the largest consumers of healthcare
- older adults (65+)
- many “frequent flyers”/readmissions
describe polypharmacy
- use of multiple meds
- interactions can lead to greater complications and diminished mental status
- risk-benefit ratio
- complicated assessment/reassessment process
describe risk-benefit ratio
relationship between the negative and positive effects of a medication, increases as patient ages
True or False?
cardiovascular disease is the number one cause of death in adults, including older adults
True
Rationale: cardiovascular disease is the number one cause of death in adults, including older adults. in patients with hypertension, the control of blood pressure is key to the prevention of cardiovascular disease
describe pharmacodynamics in older adults
- involves drug actions on target cells resulting in alterations in cellular reactions and functions
- beers criteria - guideline for providers
- prescriber vs administration nurse → nurse is responsible for knowing what they are giving
describe beers criteria
- published by the American Geriatric Society (AGS)
- list of potentially inappropriate use of medications in older adults r/t disease or drug syndrome interactions
- update every 3 years
describe prevention of adverse effects
- prone to adverse drug reactions → decrease in amount of receptors needed for drug distribution
- there are many drugs that produce adverse effects in older adults
- there are multiple strategies for preventing adverse drug reactions - such as assessing healthy history/home meds, prescription, OTC and herbals, ability to be accurate historian, and assessing lab values
what lab values are important in preventing adverse effects
- BUN/CR → indicate kidney function; elevated indicates kidneys are not functioning, increased risk for toxicity
- ALT/AST → indicates liver function; elevated levels indicates liver is not functioning, increased risk for toxicity
describe factors that may affect absorption in older adults
- GI tract changes
- decreased circulation
- decreased muscle mass
- slow absorption rates = changes in peak serum drug levels
describe some factors that may affect distribution in older adults
- diminished cardiac output
- increase body fat/lean body mass and body fluid decreases
- decrease serum albumin
describe some factors that may affect metabolism in older adults
- hepatic changes
- genetic determinants
describe some factors that may affect excretion in older adults
diminished renal blood flow/# of functioning nephrons/GFR and tubular secretion
describe factors that affect medication adherence and aging
- polypharmacy
- economic factors
- administration difficulty - vision impairment/arthritis (dexterity)
- starting slow with low doses
- asymptomatic - skip doses/discontinue medication when we feel better
describe the assessment phase of nursing process when caring for older adults r/t medication
- med list
- parameters for meds/home equipment for self monitoring vs homecare visits
- daily administration (routes/ability to swallow/read syringe markings
- altered physical condition: GI, nutrition, recent illness
describe the diagnosis phase of nursing process when caring for older adults r/t medication
- sufficient or deficient knowledge
- risk for injury/adverse drug effects
- noncompliance, overuse, underuse
describe the planning/goals phase of nursing process when caring for older adults r/t medication
- verbalizes essential drug information
- receives and takes medications as prescribed
- avoids preventable drug side effects/administers safely
describe the interventions phase of nursing process when caring for older adults r/t medication
- health promotion
- prevent/decrease need for drug therapy
- use nondrug measures to enhance side effects (diet and exercise)
- assist with appointment scheduling for follow up
describe the evaluation phase of nursing process when caring for older adults r/t medication
outcomes of the nursing process/required change
