Pharmacology portion of NCLEX review.odt

How do medications affect older adult older adults

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How do medications affect older adult? Older adults have twice as many adverse effects as younger adults due to the aging of the body systems. ****Confusion, lethargy, falls, and weakness may be mistaken for senility, rather than adverse reactions. If the adverse effects are not identified and the client continues to take the medications, the risk of toxicity increases, especially in cases of polypharmacy. What are the 9 rights to medication administration? right patient right drug right dose right route right time right documentation right action right form right response Where are medications excreted? Kidneys Where are medications metabolized? Liver What does the peak levels reflect? When should you draw peak levels? The peak levels reflect the highest concentration. When to draw peak levels: Oral intake: 1 to 2hr after administration IM: 1hr after administration IV:30 min. after administration What are trough levels? Trough levels reflect the lowest concentration or residual level and are usually obtained within 15min prior to administration of next scheduled dose. **The scheduled dose should not be given until the trough levels are confirmed. ***Typically, the drawing of the peak levels and the trough levels vary based on the half-life(the amount of time required for the body to decrease the medication blood level by 50%) of the medication.
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3 What are the guidelines for safe IV administration? Review compatibility, rate of administration, necessity infusion pump, and serious adverse reactions. NEVER administer medications through a tubing that is being used for blood administration. Fluids should be infused within 24hrs to prevent infection. Implement standard precautions and follow policies related to IV site changes. Maintain patency of IV access. How do you prevent/treat each complication associated with IV infusion: Phlebitis/thrombophlebitis: Prevent-Rotate sites q72-96hrs, secure catheter, use aseptic technique; for PICCs, avoid excessive activity with the extremity. Treatment-Stop infusion, remove IV catheter, apply HEAT compress, insert new catheter in opposite extremity. Infiltration: Prevent-Use smallest catheter for prescribed therapy, stabilize port-access, monitor blood return. Treatment- Stop infusion, remove IV catheter, apply COLD compress, elevate extremity, insert new catheter in opposite extremity. Extravasation:(fluids leaking into surrounding tissue) Prevent- Know vesicant potential before giving medication. Treatment- Stop infusion, discontinue administration set, aspirate drug if possible, apply COLD compress, document condition of site. Hematoma: Prevent-Avoid veins that are not easily seen or palpated; obtain hemostasis after insertion.
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