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  • August 11, 2024
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  • 2024/2025
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  • chapter 7 geriatric considerations

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STUVIA 2024/2025
Chapter 7: Geriatric Considerations
A 75-year-old patient is readmitted to the hospital to treat recurrent pneumonia. The patient had been
discharged home with a prescription for antibiotics 5 days prior. The nurse admitting this patient will
take which initial action?
a. Ask the patient about OTC drug use.
b. Ask the patient how many doses of the antibiotic have been taken.
c. Discuss increasing the antibiotic dose with the provider.
d. Obtain an order for a creatinine clearance test. - ✔✔ANS: B

There are many reasons for non-adherence to a drug regimen in an older patient, so if a patient is
readmitted, the nurse should first ascertain whether or not the medications have been used. Asking
the patient how many doses have been taken will help to assess this. If it is determined that the
patient is taking the drug as ordered, the other steps may be taken.

A 75-year-old patient will be discharged home with a prescription for an opioid analgesic. To help the
patient minimize adverse effects, what will the nurse recommend for this patient?
a. Sucking on lozenges to moNisten oral mucosa
b. Taking an antacid with each dose
c. Taking the medication on an empty stomach
%


d. Using a stool softener - ✔✔ANS: D

Opioid analgesics can cause constipation. Stool softeners can help minimize this effect. Opioids do
not cause dry mouth. Drug absorption may be decreased with an antacid. Opioid analgesics should
be taken with food or milk to decrease GI irritation.

An 80-year-old patient is being treated for an infection. An order for which type of antibiotic would
cause concern for the nurse caring for this patient?
a. Aminoglycoside
b. Cephalosporin
c. Penicillin
d. Sulfonamide - ✔✔ANS: A

Penicillins, cephalosporins, tetracyclines, and sulfonamides are normally considered safe for the older
adult. Aminoglycosides are excreted in the urine and are not usually prescribed for patients older than
75 years.

An older patient takes ibuprofen for arthritis pain. The patient tells the nurse that the ibuprofen causes
GI upset. Which action will the nurse take with this patient?
Ask the provider about having the patient take a different medication.


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, STUVIA 2024/2025
Instruct the patient to cut the ibuprofen dose in half to avoid GI upset.
Explain that all drugs have adverse effects.
Explore options to help decrease the drug side effects. - ✔✔ANS: D

Older adults are more likely to experience drug side effects, and nurses should be aware of the
measures that may decrease these side effects and thus improve adherence. The nurse would
additionally want to ask follow-up questions to be sure the patient is experiencing additional
symptoms that may indicate a GI bleed.

An older patient who reports a 2- to 3-year history of upper gastrointestinal (GI) symptoms will begin
taking ranitidine (Zantac) to manage her symptoms. The patient has completed a health history form.
The nurse notes that the patient answered "no" when asked if any medications were being taken.
Which action will the nurse take next?
a. Ask whether the patient uses over-the-counter (OTC) medications.
b. Obtain a careful dietary history for the past two weeks.
c. Recommend that the patient take antacid tablets.
d. Suggest that the patient add high-potassium foods to the diet. - ✔✔ANS: A

Many patients do not think of OTC products as medications and often do not list them when asked
about medication use. A patient who takes ranitidine along with an OTC antacid could be duplicating
%

therapy. A dietary history is important as well but would not be the most important action in this case.
The nurse should not recommend antacid tablets or high-potassium foods before gathering additional
information.

The nurse is caring for a 78-year-old patient who lives independently. The patient will begin a new
drug regimen that requires taking multiple drugs at various times per day. Which intervention is
appropriate for the nurse to implement with this patient?
a. Ask the patient's family members to monitor the patient's drug regimen.
b. Develop a log and/or calendar to record the times each drug will be taken.
c. Reinforce the need to take the drugs as scheduled.
d. Write the medication administration times on each prescription label. - ✔✔ANS: B

The patient should be advised to keep a medication record of drugs and when they will be taken. The
patient is independent, and this helps maintain independence. Family member support is essential
when older patients are confused. Reinforcing information without providing a means to keep track of
the medications does not necessarily improve compliance. Writing medication times on prescription
labels does not help to organize the medication schedule.

The nurse is caring for an 80-year-old patient who is taking warfarin (Coumadin). Which action does
the nurse understand is important when caring for this patient?


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