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N3 GERO > lect 3: chapter 9 > Flashcards

lect 3: chapter 9 Flashcards

1
Q

what are the two types of medications that are specifically less effective with the older population?

A

anticholinergic & sedating medications

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2
Q

what causes higher likelihood of orthostatic hypotension?

A

decreased baroreceptor reflex responses

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3
Q

anticholinergic effects

A

cannot see, pee, spit, shit

dizziness and confusion

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4
Q

which drug class is less effective in older people?

A

beta agonists & antagonists

due to decreased responsiveness of the adrenergic system

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5
Q

Beer’s List

A

a list of medications that have a higher than usual risk in older adults

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6
Q

what physiologic problems do older adults have regarding medications?

A
  • increased gastric pH
  • decreased GI motility and absorption
  • decreased metabolism
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7
Q

ginkgo biloba

A

improves memory

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8
Q

ginseng

A

reduces stress

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9
Q

echinacea

A

cold and flu therapy

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10
Q

garlic

A

prevents stroke & arteriosclerosis

that is why you can’t take it with anticoags

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11
Q

glucosamine sulfate

A

reduced joint pain

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12
Q

red yeast rice

A

lowers LDL

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13
Q

St. John’s wort

A

mostly used to treat depression (NOT bipolar disorder)

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14
Q

CoQ10

A

antioxidant

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15
Q

nursing implications for garlic, ginkgo, and ginseng

A

stop 2 weeks before surgery

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16
Q

nursing implications for St. John’s wort

A

stop 5 days before surgery

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17
Q

pain assessment (OLDCARTS)

A

Onset
Location
Duration
Characteristic
Aggravation
Relieving factors
Treatments
Severity

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18
Q

symptoms of neuroleptic malignant syndome (NMS)

A

hyperthermia, rigidity, altered mental status, tachycardia, and pallor

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19
Q

interventions for malignant syndrome

A
  • avoid direct sunlight
  • hydration
  • regular assessment of body temperature
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20
Q

what are the barriers to pain management among older adults?

A
  • HCP
  • patient (inability to assess pain in cognitively impaired) AND family
  • healthcare system (cost, time, cultural and political bias on opioid use)
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21
Q

many people believe that pain is a normal part of aging

A

true

22
Q

what factors affect pain and its assessment among the older population?

A
  • pain history
  • how it affects function
  • expressions of pain
  • social resources
  • how have they managed past pains
23
Q

pain scales for the cognitively impaired, nonverbal adults

A
  • Pain Assessment in Advanced Dementia Scale (for those who cannot reliably express their pain)
  • Pain Assessment Checklist for Seniors with Limited Ability to Communicate (observe facial expression, verbalizations, vocalizations, body movements)
24
Q

which medication does CoQ10 affect?

A

anti-hyperlipidemic or anticoagulative drugs

25
Q

what are the nursing actions for echinacea?

A

advise person not to take without provider approval

26
Q

what are the nursing actions for garlic?

A

monitor glucose levels

27
Q

what are the nursing actions for ginkgo?

A

monitor glucose levels and BP

28
Q

what are the nursing actions for red yeast rice?

A
  • warn patient of increased risk for bleeding
  • monitor glucose levels
29
Q

what are the nursing actions for St. John’s Wort?

A
  • monitor lipid levels
  • use sunscreen
  • educate that it may lower estrogen/ progesterone levels
30
Q

what are the main concerns for administrating medications by enteral tube?

A
  • occluded tube
  • reduced effects
  • drug toxicity
31
Q

what are the most common OTC meds for older adults?

A
  • GI
  • analgesics
  • cough medicine
  • eye drops
  • vitamins
32
Q

what are the most common Rx medications for older adults?

A

1) CV
2) diuretics
3) nonopioid analgesics
4) anticoagulants
5) antiepileptics

33
Q

common psychotherapeutic medications

A

1) antidepressants
2) anxiolytic agents
3) mood stabilizers
4) antipsychotics

34
Q

common SNRIs used by the older population

A

Bupropion and Trazodone

35
Q

what is the action of Buproprion?

A

reduces nicotine dependency

36
Q

what is the action of Trazodone?

A

sleep aid

37
Q

common anxiolytics for the older adults

A

Benzodiazepine and Buspirone

38
Q

bezodiazepines have a fast onset and long half life, and more likely can lead to toxicity

A

true

39
Q

buspirone must be taken daily

A

true

40
Q

buspirone takes a week to take into effect, that is why it is prescribed along with benzodiazepine (due to fast onset)

A

true

41
Q

antipsychotic medication action

A

blocks dopamine

42
Q

side effects of antipsychotic medications

A
  • sedation
  • hypotension
  • anticholinergic effects
  • EPS
  • Malignant Syndrome
43
Q

EPS

extrapyramidal symptoms

A

movement disorders

  • dystonia
  • akathisia
  • Parkinsonian symptoms
  • Tardive dyskinesia
44
Q

what do you need to look for with NMS?

A

potential for liver damage and heat stroke (due to hyperthermia and decreased thermoregulation)

45
Q

pseudoparkinsoniansim

A
  • stooped posture
  • shuffling gait
  • rigidity
  • bradykinesia
  • tremors at rest (pill rolling)
46
Q

akathisia

A
  • restless
  • trouble standing still
  • paces the floor
  • in constant motion (moving back and forth)
47
Q

acute dystonia

A

facial grimacing

involuntary upward eye movement
spasms from the neck (larynx) up to the face

48
Q

tardive dyskinesia

A
  • protrusion and rolling of tongue
  • sucking and smacking movements of lips
  • facial dyskinesia
  • involuntary mvmnts of body and extremities
  • chewing motion
49
Q

what are the indications for polypharmacy?

A
  • staying in LCT factilities
  • disabled older adults
  • multiple HCPs
50
Q

which type of drug can effectively treat neuropathic pain as an adjuvant?

A

tricyclic antidepressants

Amitriptyline, Amoxapine

51
Q

what are other types of adjuvant treatments for pain?

A
  • corticosteroids
  • topical agents
  • muscle relaxants

N3 GERO (19 decks)

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