changes with old age Flashcards
common problems and interventions related to the older adult being hospitalized and experiencing acute illness
delirium: infection, pain, side effect - provide orientation, environmental changes to help
falls
pressure ulcers
medication errors: polypharmacy, decreased liver & kidney fxn
deconditioning: muscle weakness/decreased mobility
care transitions: change from home to hospital
SPICES assessment
Sleeping disorders
Problems with eating
Incontinence
Confusion
Evidence of falls
Skin breakdown
first pass effect change
reduced; so longer in the body; metabolized slower
half life change
shorter time to base level so faster toxicity achieved
purpose of anticholinergic’s
inhibit acetylcholine (neurotransmitter) - memory, learning, attention, involuntary movement
why are anticholinergic inappropriate meds for the elderly
central: agitation, confusion, disorientation, psychosis
peripheral: urine retention, constipation, no sweating, dry secretions
name 2 anticholinergic meds
Atropine
Scopolamine
use of benzodiazepines
anti-anxiety
anti-seizure
alcohol withdraw
sedation
muscle spasm
why are benzodiazepines inappropriate meds for the elderly
long acting will cause long term confusion
name 4 benzodiazepines
Valium, Librium (long lasting)
Xanax (alprazolam), Ativan (lorazepam) - short lasting
why are NSAIDs inappropriate meds for the elderly
GI bleed due to anti-platelet activity
renal fxn decreased
congestive heart failure
cirrhosis (severe scaring of the liver)
diverticulitis
Warfarin monitoring
interferes w/ vit K required for clotting
takes 3 days to reverse effect after drug is stopped
use vit K to treat
Digoxin monitoring
narrow therapeutic range (400-600mcg normal)
digibind antidote
