chapter 3: Lifespan Considerations Flashcards

1
Q

Lifespan Considerations

A
  • The human body changes from the beginning of life to the end of life.
  • These lifespan changes have dramatic effects of the four phases of pharmacokinetics.
  • Special considerations:
  • Pregnancy
  • Newborn
  • Pediatric
  • Older adult
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2
Q

Older Adult Patients

A
  • Older adults: older than age 65 years
  • High use of medications
  • Polypharmacy
  • Noncompliance, nonadherence
  • Increased incidence of chronic illnesses
  • Sensory and motor deficits
  • Decline in organ function occurs with advancing age.
  • Drug therapy in older adults is most likely to result in adverse effects
    and toxicity.
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3
Q

Pharmacokinetics and the Older
Adult: Absorption

A
  • Gastric pH less acidic
  • Gastric emptying and movement through the GI tract is slowed
  • Blood flow to GI tract reduced
  • Absorptive surface of GI tract reduced
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4
Q

Pharmacokinetics and the Older
Adult: Metabolism

A
  • Aging liver produces fewer microsomal enzymes, affecting drug metabolism.
  • Reduced blood flow to the liver
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5
Q

Pharmacokinetics and the Older
Adult: Distribution

A
  • Lower total body water percentages
  • Increased fat content
  • Decreased production of proteins by the liver, resulting in decreased
    protein binding of drugs (and increased circulation of free drugs)
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6
Q

Pharmacokinetics and the Older
Adult: Excretion

A
  • Decreased glomerular filtration rate
  • Decreased number of nephrons
  • Drugs are cleared less effectively because of decreased excretion.
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7
Q

Nursing Process (ADPI): Assessment

A

Assessment
* Age
* Allergies to drugs and food
* Dietary habits
* Sensory, visual, hearing, cognitive, and motor-skill deficits
* Financial status and any limitations
* List of all health-related care providers
* Listing of medications
* Existence of polypharmacy
* Self-medication practices
* Laboratory test results
* History of smoking and use of alcohol
* Risk situations related to drug therapy identified by the Beers criteria

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8
Q

Nursing Process (ADPI): Diagnosis (human needs statements)

A

Human Needs Statements (Nursing Diagnosis)
* Alteration in fluids and nutrients (less than body requirements)
* Ineffective perception
* Altered safety, risk for injury
* Related to adverse effects
* Related to idiosyncratic reactions

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9
Q

Nursing Process (ADPI): Planning

A

Planning/Outcomes
* May involve patient, caregiver, or legal guardian
* Individualized

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10
Q

Nursing Process (ADPI): Implementation

A

Implementation
* Basic Nine Rights of medication administration
* Older adult considerations for safe administration
* Take as directed; do not double-up doses or discontinue without guidance from prescriber
* Safety considerations
* Be alert for polypharmacy

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11
Q

Nursing Process (ADPI): Evaluation

A

Evaluation
* Observe and monitor for therapeutic effects
* Observe and monitor for adverse effects
* Evaluate understanding of drug purpose, dose, dose frequency, adverse effects, special considerations

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