Chapter 15: Safe Medication Use

Question 1

Why do the elderly have an increased risk for drug toxicity?

Answer 1

They take their medications incorrectly. Polypharmacy, mixing drugs, combining alcohol, inappropriate or unnoted use of herbs & supplements etc…

Question 2

What do we monitor for a client taking a potassium sparing diuretic and a beta blocker for hypertension?

Answer 2

Electrolyte (esp. Potassium) levels, salt intake, weight or signs of fluid overload. Understand differences in signs of hypo vs hyperkalemia.

The diuretic helps the body get rid of excess fluid and sodium while conserving potassium. However, the beta blocker can reduce the effectiveness of the diuretic, potentially leading to fluid retention and an increase in potassium levels. This interaction can affect the balance of electrolytes in the body.

Question 3

Herbs that interact with anticoagulants & other medications

Answer 3

All have antithrombotic effects- increasing bleeding/slowing clotting.
1. Garlic: It may increase the risk of bleeding when combined with anticoagulants.

2. Ginger: It can also have blood-thinning effects and may increase the risk of bleeding.

3. Ginkgo Biloba: This herb may interfere with the effectiveness of anticoagulants, NSAIDs, and antipsychotic medications.

4. Ginseng: It may have blood-thinning properties and can interact with anticoagulants and NSAIDs.

Question 4

When discharging a patient what is the most important statement to communicate regarding medications?

Answer 4

To speak with their provider and initiate interprofessional communication regarding the patient.

Question 5

What is the most important medication information the nurse should communicate regarding medication safety?

Answer 5

The purpose of their medications

Question 6

What would demonstrate misuse of medication ?

Answer 6

Patient is reviewing their medications with their provider annually

Question 7

Pharmacokinetics and related changes

Answer 7

Increases half life for many drugs
Decreased liver and renal function

Question 8

Concerning finding regarding herbal/supplemental health for patient with uncontrolled hypertension

Answer 8

Saint Johns Wart increases BP and may cause liver damage

Question 9

Most commonly used drugs in the geriatric population

Answer 9

Antacids
Analgesics
Antihypertensives

Question 10

What Complementary therapy would not be appropriate for a patient who has N/V from chemo?

Answer 10

Aromatherapy

Question 11

Why do providers order two antibiotics at the same time?

Answer 11

They are more effective combined rather than separate/individual

Question 12

Medications used for osteoporosis & kyphosis

Answer 12

Calcium supplements, calcitonin, vitamin D & estrogen

Question 13

Drug used as an analgesic as a prototype (equianalgesic used when switching analgesics)

Answer 13

Morphine

Question 14

Signs of digoxin toxicity & what to say to a patient when levels are normal

Answer 14

Seeing halos
If levels are normal, decrease monitoring.

Question 15

How should a patient take bulk forming laxatives?

Answer 15

With lots of water

Question 16

First line of tx for Schizophrenia

Answer 16

Antipsychotics

Question 17

Medications taken to lower cholesterol & most cases of hyperlipidemia

Answer 17

Statins

Question 18

Medications offered for Alzheimer’s tx

Answer 18

Namenda (memantine)
Aricept (donepizel)
Exalon (rivastigmine)

Question 19

Foods and vitamins to avoid while on anticoagulants (end with -in)

Answer 19

Vitamin K (asparagus, bacon, beef, liver, cabbage, fish, cauliflower, & green leafy vegetables)
Vitamin E- Increase bleeding risk
Antithrombotics

Question 20

International Normalised Ratio
INR

Answer 20

A blood test that tells you how long it takes for your blood to clot
Increased by mango + papaya

Question 21

Medication contraindicated in elderly

Answer 21

Propoxyphene (darvocet)

Question 22

Which medications causes constipation

Answer 22

Narcotics, opioids

Question 23

What medication is contraindicated in clients who have a bleeding disorder and peptic ulcer disease?

Answer 23

NSAIDs, especially aspirin are associated with GI bleeding

Question 24

Big heart medications

Answer 24

Statins- to lower LDL cholesterol.
Aspirin- to prevent blood clots.
Clopidogrel- to prevent blood clots.
Warfarin- to prevent blood clots.
Beta-blockers- to treat heart attack and heart failure and sometimes used to lower blood pressure.
{End in olol; think “beta blockers are funny guys oh, lol” metoprolol, nebivolol etc…}
ACE inhibitors- to treat heart failure and lower blood pressure
{End in pril; think “A-pril” catopril, enalapril, etc…}

Question 25

Fastest route for medication

Answer 25

IV - Intravenously

Question 26

What could be happening if a 75 year old woman is having trouble losing weight & continues to gain weight?

Answer 26

Metabolism has slowed, adipose tissue increases

Question 27

Most commonly used drugs in the geriatric population

Answer 27

cardiovascular agents
antihypertensive
analgesics
antiarthritic agents
sedatives
tranquilizers
laxatives
antacids

Question 28

Tool used as reference for medications to avoid with elderly patients

Answer 28

Beers criteria

Question 29

How would a nurse give medication to a client with severe dysphagia?

Answer 29

Crushed and in their choice of applesauce, pudding, jello if they’re into that, etc…

Question 30

Promotes heart health

Answer 30

Omega 3 fatty acids