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49 Cards in this Set
- Front
- Back
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What percentage of communication with older adult is non verbal?
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80%
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What is the definition of communication?
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that the message was sent and received as intended. NOT that they agree
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Only ____ of communication is words.
_____ is verbal style _____ is body language |
7% words
38% verbal style 55% body language |
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With verbal communication, what should be utilized in speaking with older adult?
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therapeutic techniques
pace of communication (slower) tone of voice (lower, don't shout) reminiscence (realize that their life has had value) |
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What does a lab coat communicate?
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it is non verbal symbol
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What is the usefulness of group learning in the older population?
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Can be very motivating to them.
Keep it short, and repeat Old people are goal oriented |
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What is definition of personal space? why does it matter?
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18 inches, need to get their permission
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What time of the day should you perform a caring interview with the elderly?
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during midmorning peak times
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Geropharmacology
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how elderly respond to medications
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Pharmacokinetics
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What the body does to the drug
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What are the four components of pharmacokinetics?
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absorption
distribution metabolism excretion |
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What is an absorption effect that happens in the elderly?
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Altered drug absorption due to:
Altered GI motility decreased gastric acidity decreased lipid content in skin |
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Why does the absorption of drugs get altered in the elderly?
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decreased GI motilitiy
decreased gastric acidity decreased lipid content in skin |
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Why does the distribution of drugs get altered in elderly?
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increase in body fat
decrease in body water decrease in serum proteins |
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How do water soluble drugs act in the body?
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Increased toxicity b/c 15% less body water. So water soluble drugs will stay in blood stream and cause toxicity.
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What are some examples of drugs that have increased toxicity due to decreased body water?
(distribution) |
gentamycin
alcohol |
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What happens to fat soluble drugs in the body?
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get trapped in fatty tissue...so prolonged effects.
Decrease in serum proteins, so fewer available sites for protein binding. May result in increased levels of FREE or UNBOUND portion of protein bound drugs. |
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Which drugs are considered a risk b/c they are fat soluble drugs?
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dig, lasix, dilantin
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Start Low and GO Slow. You should give the adult...
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1/2 the recommended dose and then wait twice as long to dose up than literature states.
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What happens to an elderly person's liver? What does this effect?
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Hepatic Blood Flow decreases by 50%.
Decreased liver enzyme activity. Alters drug metabolism. |
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What drugs are really effected by decreased hepatic performance?
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psychotropic drugs
1st pass drugs - usually they get significantly metabolized on first pass. In elderly they don't, so 1st pass drugs would not metabolize as they should. |
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What is main diagnostic test for renal clearance?
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Creatinine.
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What should you NOT rely on for renal clearance determination?
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BUN
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What does the kidney function effect in regard to drug response?
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EXCRETION
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What is actual physiological change in renal system as a person ages?
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-renal blood flow DOWN
-decreased GFR -decreased number of functional tubules |
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What is normal renal function of elderly person?
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50% of normal adult.
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What drugs in particular are problematic in elderly due to decreased renal clearance?
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IV abx
Digoxin NSAIDS |
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What IV antibiotic in particular is problematic in elderly population?
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Vancomycin
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What else (other than kidney function) effects drug clearance?
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protein levels
fluid levels |
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Pharmacodynamics
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What the drug does to the body
(dynamic - drug to body) |
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Pharmacokinetics
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What body does to drug
(kinetic - body to drug) |
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Decreased peristalsis in GI causes drug to....
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chill out and can't get to target site
**thinking of this though, wouldn't it be decreased absorption???? |
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Decreased gastric motility causes drug to....
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delay absorption of drug
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Decreased lipid content of skin causes drug to...
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not be able to bind transdermally....so decreased absorption
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Body water in older adult
Body fat in older adult Together, these cause.... |
decreased by 15%
increased body fat together these cause increased concentration of water soluble drugs and prolonged effects of fat soluble drugs |
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Elderly have many risks associated with medication administration. What is the main reason that there are increased risks of meds in elderly?
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Risk due to cognitive or sensory changes....CAN NOT SEE LABEL #1
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What are the four risk factors for use of drugs in elderly?
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-multiple meds
-cognitive or sensory changes -inadequate knowledge -financial factors |
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The average older adult takes _____ MEDS, while in LTC, the average resident takes ______ MEDS.
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3
8 LTC |
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Financial factors may cause an elderly person to...
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skip doses or hoard outdated meds
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How do you administer G-Tube meds?
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crush each one separately. Mix with 5-10ml of water. Flush with water b/4 hand. Give one at a time.
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Latrogenesis
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harm from therapeutic regimen
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The most common ADRs (Adverse Drug Reactions) in elderly are:
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cognitive changes
falls ** anorexia nausea or weight loss |
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The most common ADR related hospitalizations are caused from which drugs?
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digoxin
insulin antibiotics |
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What are the seven rights to drug administration?
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Resident
Drug Dose Route Time Documentation To Refuse (or self Medicate) |
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Best way to determine right resident?
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look at arm band. if don't have one, then look at picture
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Make sure to include ______________ in teaching the older adult about meds.
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Family members
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Make sure to use the following philosophies when teaching older adult about drugs.
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break it up. keep it short
practice repitition group work |
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Suggest to the older adult that they only see one MD and use...
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only one pharamacy
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What is number one drug for elderly? (Most commonly used classification of drug for elderly?)
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Cardiovascular drugs
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