Nokea
The nurse is providing care to older persons in a Northern outreach clinic. Which nursing action will be most helpful in decreasing the risk for drug-drug interactions?
- A. Teach the patient to have all prescriptions filled at the same pharmacy.
- B. Instruct the patient to avoid taking over-the-counter (OTC) medications.
- C. Make a medication schedule for the patient as a reminder about when to take each medication.
- D. Have the patient bring all the medications, supplements, and herbs to every health care appointment.
Correct Answer: D
Rationale: The most information about drug use and possible interactions is obtained when the patient brings all prescribed medications, OTC medications, and supplements to every health care appointment. The patient should discuss the use of any OTC medications with the health care provider and obtain all prescribed medications from the same pharmacy, but use of supplements and herbal medications also need to be considered in order to prevent drug-drug interactions. Use of a medication schedule will help the patient take medications as scheduled but will not prevent drug-drug interactions.
You may also like to solve these questions
Which information about an older-adult patient who is being assessed by the home health nurse is of most concern?
- A. The patient organizes medications in a marked pillbox 'so I don't forget them.'
- B. The patient uses three different medications for persistent heart and joint problems.
- C. The patient says, 'I don't go on my daily walks since I had pneumonia 3 months ago.'
- D. The patient tells the nurse, 'I prefer to manage my life without much help from others.'
Correct Answer: C
Rationale: Inactivity and immobility lead rapidly to loss of function in older persons. The nurse should develop a plan to prevent further deconditioning and restore function for the patient. Self-management is appropriate for independently living older persons. The use of three medications is not unusual for an older adult. The use of memory devices to assist with safe medication administration is recommended for older persons.
The nurse is admitting an older-adult patient who is hospitalized with an acute illness. Which of the following interventions should the nurse do first?
- A. Orientate the patient to their room.
- B. Administer the prescribed PRN sedative medication.
- C. Ask the health care provider to order a vest restraint.
- D. Place the patient in a 'geri chair' near the nurse's station for observation.
Correct Answer: A
Rationale: The older adult who moves to a different location needs a thorough orientation to the environment. The nurse should repeatedly reassure the patient that he or she is safe and attempt to answer all questions. The unit should foster patient orientation by displaying large-print clocks, avoiding complex or visually confusing wall designs, clearly designating doors, and using simple bed and nurse-call systems. Physical or chemical restraints may be necessary, but the nurse's first action should be to provide an ongoing and clear physical orientation. There is no indication that the patient needs observation at this time.
The nurse is admitting an acutely ill older-adult patient to the hospital. Which of the following interventions should the nurse implement during the admission process?
- A. Speak slowly and loudly while facing the patient.
- B. Obtain a detailed medical history from the patient.
- C. Interview the patient before the physical assessment.
- D. Determine whether the patient uses glasses or hearing aids.
Correct Answer: D
Rationale: Assistive devices should be in place before assessing the patient to minimize anxiety and confusion. When a patient is acutely ill, the physical assessment should be accomplished first to detect any physiological changes that require immediate action. Not all older patients have hearing deficits, and it is insensitive of the nurse to speak loudly and slowly to all older patients. To avoid tiring the patient, much of the medical history can be obtained from medical records.
Which of the following actions should the nurse consider when developing the plan of care for an older adult who is hospitalized for an acute illness?
- A. Use a standardized geriatric nursing care plan.
- B. Minimize activity level during hospitalization.
- C. Plan for transfer to a long-term care facility after the hospitalization.
- D. Consider preadmission functional abilities when setting patient goals.
Correct Answer: D
Rationale: The plan of care for older persons should be individualized and based on the patient's current functional abilities. A standardized geriatric nursing care plan will not address individual patient needs and strengths. A patient's need for discharge to a long-term care facility is variable. Activity level should be designed to allow the patient to retain functional abilities while hospitalized and also to allow any additional rest needed for recovery from the acute process.
The nurse is teaching an older-adult female patient about her new medications and the patient replies that she 'just can't remember all that information anymore.' Which of the following changes may interfere with the patients' ability to learn about the new medications?
- A. Intellectual ability declines with age.
- B. All mental abilities slow as individuals age.
- C. Declining physical health can impair cognitive function.
- D. Impaired vocabulary and verbal function decrease reasoning with age.
Correct Answer: C
Rationale: Declining physical health is an important factor in cognitive impairment. Intellectual ability does not decline with age. All mental abilities do not slow as an individual ages. Vocabulary and verbal function do not decrease with age.