A nurse is reviewing an older adult patient’s chart before giving medications. Which patient information is of most concern?

Correct Answer: C

Rationale: In pharmacology, considering lifespan factors is crucial when administering medications to older adult patients to ensure safe and effective care. In this scenario, the correct answer is C) Low serum albumin. Low serum albumin in an older adult patient is of most concern when reviewing medication charts because albumin is a protein that plays a critical role in drug binding and distribution in the body. In older adults, decreased albumin levels can lead to higher concentrations of free drug in the bloodstream, potentially increasing the risk of drug toxicity or adverse effects. Therefore, monitoring albumin levels is essential to adjust medication dosages appropriately in older adults. Now let's analyze why the other options are incorrect: A) Chronic constipation: While chronic constipation may impact medication absorption and elimination, it is not the most concerning factor compared to low serum albumin in this context. B) Increased body fat: Although body fat distribution can affect drug distribution and metabolism, it is not as critical as low serum albumin in determining medication dosages in older adults. D) Low serum creatinine: Low serum creatinine levels may indicate decreased muscle mass or impaired kidney function, but it is not as directly related to medication dosages as low serum albumin. Understanding the importance of assessing serum albumin levels in older adult patients helps nurses make informed decisions when administering medications, ensuring patient safety and optimal therapeutic outcomes. It highlights the need for individualized care based on physiological changes associated with aging to prevent medication-related complications.

Correct Answer: B

Rationale: Carbamazepine, a P450 inducer, accelerates OC metabolism, reducing estrogen levels and causing breakthrough spotting. Increasing the estrogen dose can compensate for this. Condoms alone (A) abandon hormonal benefits, altering carbamazepine (C) affects its efficacy, and stopping OCs (D) risks pregnancy, making option B the best advice.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Edema at the IV insertion site, as it would cause the most concern when administering intravenous dopamine. Dopamine is a potent vasoactive medication that can cause extravasation injury if it infiltrates into the surrounding tissues. Edema at the IV insertion site indicates a potential infiltration of dopamine, leading to tissue damage and compromised circulation in the affected area. Option A) Blood pressure of 100/70 mm Hg is not the most concerning finding because dopamine is used to increase blood pressure in patients with hypotension. Increased urine output (Option B) is an expected response to dopamine, as it is a diuretic medication that helps improve kidney function. Option D) Headache is a common side effect of dopamine but is not as concerning as the possibility of tissue damage from infiltration. Educationally, understanding the potential complications of IV medication administration is crucial for nurses, especially in the intensive care unit where patients are often receiving high-risk medications. Recognizing signs of infiltration early can prevent serious complications and promote patient safety. Nurses must be vigilant in assessing IV sites and promptly addressing any signs of infiltration to prevent further harm to the patient.

Correct Answer: D

Rationale: Nonselective beta-blockers are commonly used to treat hypertension and supraventricular arrhythmias due to their ability to block beta receptors in the heart, leading to decreased heart rate and contractility. This helps in reducing cardiac workload and oxygen demand, thereby managing these conditions effectively. Option A, chronic obstructive pulmonary disease (COPD), is incorrect because nonselective beta-blockers can exacerbate bronchoconstriction in patients with COPD due to their action on beta-2 receptors in the lungs, potentially leading to respiratory distress. Option B, heart failure, is incorrect because nonselective beta-blockers are not typically used in heart failure management. Instead, selective beta-blockers targeting beta-1 receptors are preferred as they provide benefits without compromising cardiac function. Option C, heart block, is incorrect because nonselective beta-blockers can worsen heart block by further slowing down the electrical conduction through the heart's conduction system, potentially leading to more serious rhythm disturbances. Educationally, understanding the pharmacological properties of beta-blockers and their selectivity is crucial for healthcare professionals in making informed decisions regarding their use in different clinical scenarios. It is essential to consider the specific effects of medications on different organ systems to optimize patient care and avoid potential complications.

Correct Answer: A

Rationale: In this case, the correct answer is A) hepatic toxicity. Acetaminophen is primarily metabolized in the liver, and when taken in excess or in combination with alcohol, it can lead to liver damage. This is a crucial consideration for the nurse to monitor in a client who regularly consumes acetaminophen and alcohol. Option B) renal damage is incorrect because acetaminophen primarily affects the liver, not the kidneys. Option C) thrombotic effects and Option D) pulmonary damage are also incorrect as they are not commonly associated with acetaminophen use. Educational Context: Understanding the potential adverse effects of medications like acetaminophen is essential for nurses and healthcare professionals to ensure patient safety. It is important to educate clients on the proper use of medications, including dosage and any potential interactions or risks associated with their use. Monitoring for adverse effects is a key role of the nurse in promoting patient well-being and preventing complications.