114 Pharm Midterm, Ch 8

Front 1

Misfeasance

Back 1

negligence; giving the wrong drug or dose that results in great harm patient's death

Front 2

Nonfeasance

Back 2

omission; omitting a drug dose that results in great harm patient's death

Front 3

Malfeasance

Back 3

giving the correct drug but by the wrong route that results in great harm patient's death

Front 4

___ ____ ___ are state laws regarding drug administration by nurses and they vary from state to state.

Back 4

Nurse Practice Acts

Front 5

______ Sets standards for individual identifiable health information
Gives patients more control over their health records

Back 5

HIPAA

Front 6

Nurse’s primary obligation is to ________________.

Back 6

The patient

Front 7

Define geriatric patient

Back 7

"The older adult", a person who is 65 years of age or older

Front 8

Define frail elderly

Back 8

All people older than 65 yrs of age who have one or more debilitating conditions

Front 9

The “oldest old”

Back 9

>85y/o
fastest growing population

Front 10

Polypharmacy

Back 10

Taking multiple medications simultaneously

Front 11

One importance of Geropharmacology is to prevent/decrease ____ _____ _____ in the older population ( this causes 106,000 fatalities/yr.)

Back 11

adverse drug reactions

Front 12

0-39% of all persons are hospitalized because of ____ related problems
*2 examples?

Back 12

drug

adverse drug reactions, noncompliance

Front 13

There is a general decline in the _____ function of the elderly patient, which impacts drug therapy.

Back 13

organ

Front 14

Why would the older population have drug problems r/t noncompliance?

Back 14

*a decrease in income means they cannot afford their drugs*
-forgetting to take their meds
-eyesight, taking the wrong drug or dose

Front 15

why do the older adults have more problems with polypharmacy?

Back 15

They are on more medications (prescribed, OTC, herbal, etc.) than the rest of the population

Front 16

What adverse effects would the geriatric population have on the CNS?

Back 16

changes in mental status because the BLOOD BRAIN BARRIER is not as selective in older adults

Front 17

Why are renal tests not as accurate with the geriatric population?

Back 17

loss of muscle mass = >creatinine. This will show abnormal results, but is normal for that person.

Front 18

Problems with memory in the older population.

Back 18

retrieval can be slowed *if not used on a regular basis* (use it or lose it*

Front 19

How can older adults help with their memory problems?

Back 19

memory aids

Front 20

Changes with vision in the older population.

Back 20

changes in the eyes leads to decreased vision

Front 21

Changes in hearing with the older population

Back 21

High frequency loss
equilibrium problems
more ear wax

Front 22

Changes with respiratory system with the older population

Back 22

weaker muscles
chest wall stiffens
increased use of accessory muscles

Front 23

Changes in digestion/nutrition with the older population

Back 23

decreased sense of taste
less efficient chewing
slower motility

Front 24

Changes in Urinary elimination with the older population

Back 24

*kidney: decreased blood flow*
*urinary muscles: hypertrophy of bladder muscle*

Will be on test

Front 25

Changes in Musculoskeletal/Mobility with the older population

Back 25

diminished muscle mass
degenerative changes in joints
changes in gait

Front 26

The pharmacokinetic processes may be affected or impaired by the normal physiologic changes of aging BUT…the ___ ___ is more likely than age related changes to alter the older adults pharmacokinetics

Back 26

disease process

Front 27

Changes affect _______& _____ of the systemic availability of a drug.

Back 27

extent and duration

Front 28

Although absorption seems to be the least affected pharmacokinetic process during aging in the older adult , 1.____, 2._____ 3._____ ,& 4._____may influence the rate of absorption.

Back 28

1. increase in gastric pH
2. decreased rate of blood flow
3. decrease in GI motility
4. decrease in BSA

Will be on test

Front 29

The overall effects of aging on the__ __ _____ result in a slowed drug absorption rate.

Back 29

Gastro Intestinal Tract

Front 30

Several physiologic factors affect the distribution of a drug in older adults, including:
decreased ___ ____
reduced plasma ____ levels
less effective ____-____ ____

Back 30

body mass
albumin
blood–brain barrier

Front 31

Other age-related factors that may affect drug distribution include declining ______ _____, extreme changes in body weight, poor _____, dehydration, inactivity, and extended bed rest.

Back 31

cardiac output
nutrition

Front 32

________ efficiency gradually declines with age.

Back 32

Metabolism

Front 33

In the older adult, three major physiologic changes occur that effect metabolism:
1. the size of the liver changes.
2. blood flow to the ____ declines.
3. the ability to _____ drugs is reduced.

Back 33

1. liver
2. liver
3. metabolize

Front 34

Nurses may mistakenly interpret an older patient’s altered cognition as normal rather than the effect of a ____.

Back 34

drug

Front 35

Aging can substantially ______ renal efficiency.

Back 35

decrease

Front 36

A normal ______ level does not indicate normal renal function in elderly patients.

Back 36

*creatinine

Will be on test

Front 37

Because absorption is _______in the older adult, response to single doses of drugs is commonly delayed.

Back 37

prolonged

Front 38

The drug receptors in the older adult:

Back 38

Do not function as efficiently

Front 39

Decreases in the number of ______ are also associated with decreases in the respective neurotransmitters themselves.

Back 39

receptors

Front 40

Due to the older adult’s decreased ___ function and possibly ______ function, many drugs should be used with caution.

Back 40

renal
metabolic

Front 41

The Beers criteria

Back 41

Is a list of possibly inappropriate medications for the elderly

*will be on test*

Front 42

Use of inappropriate ____ may be a substantial problem in the current health care system.

Back 42

drugs

Front 43

The major organ systems (cardiovascular, respiratory, GI, genitourinary, endocrine, and others) all become much ___ ____ with advancing age.

Back 43

less efficient

Front 44

Decline in ____ function results in health problems that often require drug therapy.

Back 44

organ

Front 45

When assessing the older patient’s health status, assess for _________.

Back 45

polypharmacy

Front 46

_______ should always include a thorough inventory of all the drugs the patient is currently taking, dosage, and dosing schedule.

Back 46

Assessment

Front 47

Gaps in the knowledge of older adult patients indicate that _____ about drug therapy is needed.

Back 47

teaching

Front 48

Assess whether the older adult patient is taking the medication as _______.

Back 48

prescribed

Front 49

Assessment of several basic areas of ____ _____ is essential in drug therapy.
Swallowing difficulties?
Use of alt. medications?
BMs?
Exercise?
Dietary?

Back 49

daily living

Front 50

The ____ ____s of older patients is extremely important to their quality of life.

Back 50

mental statu

Front 51

____ regarding drug therapy should be considered when planning drug administration in the hospital.

Back 51

Habits

Front 52

Because older adults typically have ____ _____, question patients to determine whether their health insurance includes payment or partial payment for drug therapy.

Back 52

fixed incomes

Front 53

When assessing a geri patients ______, determine whether the patient lives alone or with other family members.

Back 53

environment

Front 54

When assessing a geri patients environment, assess the patient’s access to a _____.

Back 54

pharmacy

Front 55

Be sensitive to beliefs and ___ _____ that may have an effect on drug therapy.

Back 55

cultural values

Front 56

Some ethnic or cultural groups still practice ___ _____.

Back 56

folk medicine

Front 57

The number of some of the cytochrome P-450 isoenzymes, needed for drug metabolism, may vary based on ____ _____ traits.

Back 57

genetic inherited

Front 58

In order to maximize therapeutic effects,
_____ must be taken at the appropriate times.

Back 58

dose

Front 59

_______ does not always mean that the patient directly refuses to follow the recommended drug therapy schedule.

Back 59

Nonadherence

Front 60

In order to maximize therapeutic effects, make ____ ______ as easy to follow and as uncomplicated as possible.

Back 60

drug regimens

Front 61

Drugs should be used with great caution in older adults because these patients exhibit a narrow ___-_-____ ratio.

Back 61

risk-to-benefit

Front 62

Older adults are at increased risk for drug ____ or _____.

Back 62

overdose or toxicity

Front 63

Obtain a current _____ _____ and an accurate history of the patient’s usual abilities and changes in abilities or health status.

Back 63

drug profile

Front 64

___ _____ should be included in Pt. and family education to help prevent confusion
regarding drug use
times of administration.

Back 64

Written instructions

Front 65

Teach about expected or possible ___ _____ and
How to differentiate between them and normal signs of aging.

Back 65

adverse effects

Front 66

What can we, as nurses, do to help the geriatric population in regards to maximizing therapeutic effects and minimizing adverse effects? ____ _____

Back 66

Health Teaching
(teaching aids, hearing aids, cleaning glasses, change tone of voice)