Which strategy should be included in the education of an elder adult to prevent polypharmacy?

Encourage elderly clients to keep a list of all medications, including dose and frequency, with them at all times.

Provide only written instructions for medications to elderly clients.

Encourage patients to use multiple pharmacies for convenience.

Teach elderly clients to have a spouse or family member be responsible for of all of their medications.

Answer and Explanation

The Correct Answer is A

A. Encourage elderly clients to keep a list of all medications, including dose and frequency, with them at all times:
Maintaining an accurate list of all medications, including doses and frequencies, helps prevent polypharmacy by ensuring that healthcare providers have a complete picture of what the patient is taking. This list can be critical in preventing drug interactions, avoiding duplicate therapies, and ensuring that the patient does not inadvertently take conflicting medications. It also aids in coordinating care among multiple providers.

B. Provide only written instructions for medications to elderly clients:
While written instructions are helpful, relying solely on them may not be sufficient. Elderly clients may have difficulty reading or understanding written instructions due to various factors like visual impairments or cognitive decline. A comprehensive approach, including verbal instructions and opportunities for clarification, is often more effective.

C. Encourage patients to use multiple pharmacies for convenience:
Using multiple pharmacies can increase the risk of polypharmacy because it may lead to a lack of coordination and awareness of all the medications the patient is taking. A single pharmacy or a centralized medication management system is generally more effective in tracking and managing medications to avoid interactions and duplications.
D. Teach elderly clients to have a spouse or family member be responsible for all of their medications:
While involving family members in medication management can be beneficial, it is not a strategy to prevent polypharmacy. The primary responsibility for managing medications should lie with the patient, in collaboration with healthcare providers, to ensure accuracy and understanding. Family members can assist, but they should not replace the need for personal medication management and monitoring.

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Correct Answer is A

Explanation

A. The drug will be more effective when given in a nonenteral route:
Morphine has a high first-pass effect when taken orally, meaning that a significant amount of the drug is metabolized in the liver before it reaches systemic circulation. This reduces the amount of active drug available in the bloodstream. To avoid this extensive metabolism, morphine is often administered through nonenteral routes, such as intravenous or subcutaneous, where it bypasses the digestive system and liver first-pass metabolism, resulting in higher systemic bioavailability and effectiveness.

B. The drug will be most effective when given orally:
Due to the high first-pass effect of oral morphine, a significant portion of the drug is metabolized by the liver before it reaches systemic circulation. This means that oral morphine is often less effective compared to other routes of administration, such as intravenous, because the bioavailability of the drug is reduced.

C. The drug is excreted by the kidneys at a slower rate than most medications:
The high first-pass effect primarily affects the drug's absorption and systemic availability rather than its excretion rate. The rate at which a drug is excreted by the kidneys is generally unrelated to its first-pass effect. Morphine’s excretion is influenced by its metabolism and clearance, but not directly by the first-pass effect.

D. The kidney will metabolize some of the drug before it reaches the bloodstream:
The first-pass effect occurs primarily in the liver, not the kidneys. It involves the metabolism of the drug by the liver before it reaches systemic circulation. Therefore, this option incorrectly attributes the first-pass effect to kidney metabolism.

A. Report the incident immediately to your supervisor upon noticing. B. Gather reversal agents to administer to the client C. Notify the client's provider immediately while present with the client. D. Assess the client's vital signs.

Correct Answer is D

Explanation

A) Report the incident immediately to your supervisor upon noticing: Reporting the incident is an important step, but it should come after assessing the client's condition. Immediate assessment of the client's vital signs and overall status takes precedence to address any potential immediate health impacts due to the medication error.

B) Gather reversal agents to administer to the client: Gathering reversal agents is a critical step if the medication administered poses an immediate risk and reversal is necessary. However, this action should follow an initial assessment of the client's condition to determine if reversal is needed.

C) Notify the client's provider immediately while present with the client: Notifying the provider is essential to receive guidance on how to manage the medication error. Nonetheless, the first priority should be to assess the client's condition to provide accurate information to the provider.

D) Assess the client's vital signs: The initial action should be to assess the client’s vital signs and overall condition to determine any immediate effects of the incorrect medication. This assessment helps in identifying if the client is experiencing any adverse reactions or complications, which will guide subsequent actions such as notifying the provider and administering reversal agents if needed.

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Which strategy should be included in the education of an elder adult to prevent polypharmacy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse reads in a drug information guide that PO morphine has a high first-pass effect. Which of the following would the nurse expect?

Correct Answer is A

Explanation

A nurse is caring for four clients. After administering morning medications, she realizes that a drug prescribed for one client was inadvertently administered to another client. Which of the following actions should the nurse take first?

Correct Answer is D

Explanation

Select the correct order in which pharmacokinetics process occur when a medication is taken via the oral route.

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The nurse is preparing to administer medications to a 54-year old client. Which medications taken would be affected by the first-pass effect? (Select All that Apply.)

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