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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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. “It is caused by an infection of the prostate gland that leads to inflammation and enlargement.”. B. “It is caused by a hormonal imbalance that stimulates the growth of prostate tissue.”. C. “It is caused by a genetic mutation that triggers abnormal cell division in the prostate.”. D. “It is caused by an autoimmune disorder that attacks and damages the prostate tissue.”.

Correct Answer is B

Explanation

The correct answer is B.

It is caused by a hormonal imbalance that stimulates the growth of prostate tissue.

• Choice A is wrong because BPH is not caused by an infection of the prostate gland.Prostate infections are called prostatitis and have different symptoms and treatments than BPH.

• Choice C is wrong because BPH is not caused by a genetic mutation that triggers abnormal cell division in the prostate.Prostate cancer is a malignant condition that involves uncontrolled cell growth in the prostate, but it is not the same as BPH.

• Choice D is wrong because BPH is not caused by an autoimmune disorder that attacks and damages the prostate tissue.Autoimmune disorders are conditions where the immune system mistakenly attacks healthy cells in the body, but they are not known to cause BPH.

The exact cause of BPH is unknown, but it is believed to be related to aging and hormonal changes in older men.The prostate gland grows throughout a man’s life, but it usually does not cause problems until later in life.Some factors that may increase the risk of BPH include family history, diabetes, heart problems, obesity, and prostate cancer.

BPH can cause symptoms such as difficulty urinating, frequent or urgent urination, weak or interrupted urine stream, dribbling at the end of urination, incomplete bladder emptying, nocturia (urination at night), urinary incontinence (leakage of urine), urinary retention (inability to urinate), blood in urine, and painful urination.These symptoms can affect the quality of life and lead to complications such as urinary tract infections, bladder stones, bladder damage, kidney problems, and acute urinary retention.

BPH can be diagnosed by a physical exam, medical history, and various tests such as urinalysis, urodynamic test, prostate-specific antigen (PSA) test, post-void residual test, and cystoscopy.

The treatment options depend on the severity of symptoms, the size of the prostate, and other health conditions.They include medications, surgery, and other procedures such as laser therapy or microwave therapy.Some natural treatments such as lifestyle changes, dietary supplements, and herbal remedies may also help with mild symptoms of BPH.

Normal ranges for some tests related to BPH are:.

• PSA test: The normal range for PSA levels is 0 to 4 nanograms per milliliter (ng/mL) of blood.

However, this range may vary depending on age, race, and other factors.Higher PSA levels may indicate prostate cancer or other prostate problems such as BPH or prostatitis.

• Post-void residual test: The normal range for post-void residual volume is less than 50 milliliters (mL) of urine.Higher volumes may indicate urinary retention or bladder dysfunction due to BPH or other causes.

• Urodynamic test: The normal range for urodynamic parameters such as bladder pressure, urine flow rate, and bladder capacity may vary depending on age, gender, and other factors.Abnormal values may indicate bladder obstruction or dysfunction due to BPH or other causes.

References:.

:What is Benign prostatic hyperplasia and its possible symptoms ….

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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?

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Naxlex Comprehensive Predictor Exams

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

Explanation

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Correct Answer is B

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?