A nurse is caring for a client who has chronic hypertension. The client's morning vital signs include BP 140/80 mm Hg, heart rate 54/min, and respiratory rate 18/min. Which of the following medications should the nurse plan to withhold?

D. One of the primary requirements of the iPledge program for sexually active females of childbearing potential is the use of two forms of contraception simultaneously, beginning one month before starting isotretinoin therapy, throughout therapy, and for one month after discontinuation of therapy. This is to ensure effective contraception and prevent pregnancy due to the teratogenic effects of isotretinoin.
A. While mammograms are important screening tests for breast cancer, they are not a requirement of the iPledge program for female clients receiving isotretinoin.
B. Papanicolaou (Pap) tests, which screen for cervical cancer, are not a requirement of the iPledge program. However, sexually active females of childbearing potential must have monthly pregnancy tests and must agree to use two forms of contraception simultaneously during isotretinoin therapy.
C. There is no requirement for clients to take a daily supplement of vitamin A prior to initiating isotretinoin therapy as part of the iPledge program.

A. Renal function typically declines with age, leading to a decrease in glomerular filtration rate (GFR) and renal blood flow. As a result, medications may be excreted more slowly from the body, leading to an increased risk of drug accumulation and potential toxicity. Adjustments in medication dosages or dosing intervals may be necessary to account for this age-related change.
B. Brain receptors do not change significantly. However, older adults may require lower doses to achieve the same therapeutic effect due to reduced receptor sensitivity.
C. Gastric emptying tends to slow down with age rather than increase. Delayed gastric emptying can affect the absorption of orally administered medications, leading to unpredictable drug levels and potentially reduced efficacy.
D. Hepatic function generally decreases with age, leading to a decline in the metabolic capacity of the liver. This can result in slower drug metabolism and clearance, prolonging the duration of action of medications and increasing the risk of adverse effects.