Polypharmacy Flashcards

0
Q

What makes a good team

A

Shared purpose
Open Communication
Recognition and Respect for one
another’s contribution
Structure or process for meeting and
carrying out roles
Trust
Organizational support
Willingness to collaborate

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1
Q

Atypical presentation

A

Vague presentation of illness Altered presentation of illness Non presentation of illness

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2
Q

3 types of trust

A

Competence trust

Contractual trust

Communication trust

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3
Q

Competence trust

A

“Trust of capability” - acknowledge skills and abilities - allow people to make decisions - involves the others and seeks input - help people learn skills

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4
Q

Communication trust

A

“Trust of disclosure” Share info Tell the truth Admit mistakes Give and receive constructive feedback Maintain confidentiality Speak with good purpose

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5
Q

Contractual trust

A

Trust of character

  • manage expectations
  • estabilish boundaries
  • delegate appropriately
  • encourage mutually serving intentions
  • keep agreements
  • be consistent
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6
Q

Core competencies for inter professional practice

A

KNOWLEDGE
Roles of other health professionals
SKILLS
Communicating with others and reflecting
upon
my role and others
ATTITUDES
mutual respect
willingness to collabora

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7
Q

What makes a team successful

A
  • Interactional determinants(moods, attitude) -Organizational determinants (fall risk assessment team, how they’re set up, is there a hierarchy) -Systemic determinants (what does your licensing body tell you that you can do, policies and rules)
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8
Q

What’s polypharmacy ?

A

Many drugs More than 5 Indicates the use of more medications then clinically indicated or warranted - mobility - do they have more than one prescriber - renal failure - cognitive impairment - recent change in health or functional status

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9
Q

Factors leading to polypharmacy

A

Physician factors - presuming pts expect meds - prescribe without proper assessment - poor instruction - lack of med review - automatic refills - lack of knowledge Patient factor - seeing multiple physicians - hoarding - not reporting all medications - assumption that meds should be taken indefinitely - changes to daily habits

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10
Q

Problems with polypharm

A

ADRs especially with OTC Drug drug interactions Decreased medication compliance Poor quality of life Unnecessary drug expense

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11
Q

Body drug distribution in older adults

A

Decreased renal function Less water in the body ARCs Adipose tissue: lean muscle mass is altered Nurse role: Serum albumin levels Hypoalbuminia Dehydration

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12
Q

Beers criteria (must know)

A

High risk categories 1. Anticholinergics (dry mouths, urinary retention, OHTN, confusion, vision change) 2. Tricyclics (sedating, confusion, falls) 3. Antiemetics (drowsy) 4. Digoxin (heart, digoxin toxicity) 5. H2 blockers ( confusion) 6. Benzodiazepines ( just bad) 7. Narcotics

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13
Q

Interventions

A

Do not treat side effects with another medication Frequent med reviews Decrease if possible Add one at a time

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14
Q

age related changes and polypharmacy

A

Decreased body water
Decreased lean tissue
Increased body fat
Decreased serum albumin
levels
Decreased liver and
renal function
Altered homeostatic
mechanisms
Altered receptor

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15
Q

Negative function consequences of polypharmacy

A

•Increased
probability of
adverse effects
•Unpredictable
therapeutic effect
•Mental changes
and other
•functional
impairments

16
Q

risk factors of polypharmacy

A

Pathologic processes
Functional Impairment
Inappropriate
prescribing
Polypharmacy
Inadequate
monitoring
Financial Factors
Insufficient recognition
of adverse effect

17
Q

steps for drug reconciliation

A
  1. verificationby collecting an accurate list
  2. clarification questions about drugs, doses, frequency, and other drug pertinant information
  3. reconciliation of any discrepencies or concerns by communicating with prescribing practitioner
18
Q

Complexity?

A

Older adults have a higher
vulnerability to illness…more
likely to develop chronic
illnesses
Threshold for disability lessens,
potential for increased “frailty”