A nurse is reviewing the medication list of an older adult client who takes several medications for different health problems.

The nurse recognizes that polypharmacy in older adults can increase the risk of which of the following?

Adverse drug reactions.

Medication adherence

Drug-drug interactions.

Therapeutic effects.

Answer and Explanation

The Correct Answer is A

The correct answer is A.

Adverse drug reactions.

Polypharmacy, which refers to the effects of taking multiple medications concurrently to manage coexisting health problems, is common among older adults.

It is defined as the regular use of at least five medications.

Polypharmacy can lead to an increase in geriatric syndromes, decrease in functional outcomes, and increased mortality.

One of the major risks of polypharmacy is adverse drug reactions, which are harmful or unintended effects of a medication that occur at normal doses.

Adverse drug reactions can result from drug-drug interactions, drug-disease interactions, drug-age interactions, or inappropriate prescribing.

Adverse drug reactions can cause symptoms such as confusion, dizziness, falls, bleeding, or organ damage.

They can also lead to hospitalizations, increased health care costs, and reduced quality of life.

Choice B is wrong because medication adherence, which is the extent to which patients take medications as prescribed by their health care providers, can actually decrease with polypharmacy.

This is because taking multiple medications can be complex, costly, and burdensome for older adults, especially if they have cognitive impairment or low health literacy.

Medication adherence can also be influenced by patients’ beliefs, preferences, and expectations about their medications.

Choice C is wrong because drug-drug interactions are not a risk of polypharmacy per se, but rather a cause of adverse drug reactions.

Drug-drug interactions occur when two or more drugs affect each other’s pharmacokinetics (absorption, distribution, metabolism, excretion) or pharmacodynamics (mechanism of action, efficacy, toxicity).

Drug-drug interactions can alter the therapeutic effects or safety of a medication.

Choice D is wrong because therapeutic effects are the intended or desired effects of a medication that benefit the patient’s health condition.

Therapeutic effects can decrease with polypharmacy due to drug-drug interactions that reduce the efficacy of a medication.

Therapeutic effects can also be diminished by prescribing cascade, which is a phenomenon where a new medication is prescribed to treat a symptom that is actually an adverse drug reaction of another medication.

Normal ranges for blood pressure are.

≤120/80.

mmHg for normal,.

120−129/80.

mmHg for elevated,.

130−139/80−89.

mmHg for stage 1 hypertension, and.

≥140/90.

mmHg for stage 2 hypertension.

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Free Nursing Study Resources

Correct Answer is ["A","B","C","E"]

Explanation

The correct answer isA, B, C, and E.

The nurse should ask the client about medications, vision problems, home environment, and urinary incontinence as these are all factors that could contribute to falls in older adults.

• Medicationscan increase the risk of falls because they can cause side effects such as drowsiness, dizziness, confusion, or low blood pressure.Some medications that can increase the risk of falls include sedatives, antidepressants, antihypertensives, diuretics, and anticholinergics.

• Vision problemscan impair the ability to see obstacles, judge depth and distance, or adjust to changes in light.Some vision problems that can increase the risk of falls include cataracts, glaucoma, macular degeneration, and diabetic retinopathy.

• Home environmentcan pose safety hazards that can cause tripping, slipping, or losing balance.Some home hazards that can increase the risk of falls include loose rugs, clutter, poor lighting, slippery floors, uneven surfaces, and lack of handrails or grab bars.

• Urinary incontinencecan lead to rushed movements to the bathroom or frequent nighttime trips that can increase the risk of falls.Urinary incontinence can be caused by various factors such as bladder infections, prostate problems, pelvic floor weakness, or medication side effects.

Choice D is wrong because thyroid function is not a direct factor that contributes to falls in older adults.However, thyroid disorders such as hyperthyroidism or hypothyroidism can affect other factors such as muscle strength, bone density, heart rate, or blood pressure that can indirectly increase the risk of falls.

Normal ranges for thyroid function tests vary depending on the laboratory and the method used.However, a common reference range for thyroid-stimulating hormone (TSH) is 0.4 to 4.0 mIU/L and for free thyroxine (FT4) is 0.8 to 1.8 ng/dL.

A. Assess the location, intensity, quality and duration of the pain using a pain scale B. Administer analgesic medications as prescribed and monitor for effectiveness and side effects. C. Provide non-pharmacological interventions such as massage, heat or cold therapy, relaxation techniques or distraction. D. All of the above.

Correct Answer is D

Explanation

The correct answer isD.

All of the above.

The nurse should take all of the actions listed to provide effective pain management for the older adult client who has depression and chronic pain in his lower back.

• Choice Ais correct because assessing the pain using a valid and reliable pain scale is essential for determining the severity and impact of pain, as well as monitoring the response to treatment.

• Choice Bis correct because administering analgesic medications as prescribed can help reduce pain and improve function.

The nurse should also monitor for effectiveness and side effects, especially in older adults who may have altered drug metabolism, polypharmacy, and increased risk of adverse events.

• Choice Cis correct because providing non-pharmacological interventions can enhance pain relief, reduce medication use, and address the biopsychosocial aspects of pain.

Massage, heat or cold therapy, relaxation techniques, and distraction are some examples of non-pharmacological interventions that can be used for chronic pain in older adults.

• Choice Dis correct because it includes all of the above actions, which are part of a multimodal approach to pain management that is recommended by clinical guidelines.

4 7 A multimodal approach can improve pain outcomes, reduce side effects, and address the complex needs of older adults with chronic pain.

A. Assess the location, intensity, quality and duration of the pain using a pain scale B.

Administer analgesic medications as prescribed and monitor for effectiveness and side effects C.

Provide non-pharmacological interventions such as massage, heat or cold therapy, relaxation techniques or distraction D.

All of the above

View Question and Answer

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A nurse is reviewing the medication list of an older adult client who takes several medications for different health problems. The nurse recognizes that polypharmacy in older adults can increase the risk of which of the following?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is ["A","B","C","E"]

Explanation

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Correct Answer is D

Explanation

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A nurse is reviewing the medication list of an older adult client who takes several medications for different health problems.

The nurse recognizes that polypharmacy in older adults can increase the risk of which of the following?