A nurse is caring for an older adult client who is to undergo total hip arthroplasty....
A nurse is caring for an older adult client who is to undergo total hip arthroplasty. What physiological changes should the nurse consider when administering medications to the client?
Homework Answers
The nurse should consider physiology of aging when administering medication to an elderly patient. Older adults are at risk of serious adverse effects of drugs due to the physiological and pathophysiologycal changes due to aging. Aging influence the absorption, distribution, metabolism and elimination of drug (Pharmacokinetics) as well as the effect of drug in the body (Pharmacodynamics).The changes of aging in older adults produce intense or prolonged response to the medication comparing to young adults due to alteration in sensitivity of receptors binding the medication in target organs.
Nursing considerations when administering medications to an older adult
1.Changes in body composition; older adult will have more fat and less proportion of water in the body which increases the volume distribution and half-life of fat-soluble (lipophilic) drugs and increase in serum concentration of water soluble drugs.Thus they may need an alternative medication or lower dose of medication to prevent prolonged action or over dosing of drugs.
2.Decreased Metabolic Rate; The older adults have low Metabolic rate so the drug metabolism in the body will be very slow. Thus, they may experience prolonged effects of drugs.
3.Decreased Cardiac Output; Decrease blood supply in body organs especially in digestive system affect the oral drugs and reduce the absorption rate and distribution. decreased blood flow to liver and kidneys reduce the metabolism and elimination of drugs.
4.Decreased gastrointestinal motility; The medication can stay for a long period of time in the stomach and can cause stomach irritation and ulceration.
As the age advances, many physiological changes take place which need to be considered before giving medication. These changes are:
- increased body fat because of which volume of distribution of lipophilic drugs increase.
- decreased body water content
- Decreased renal and liver function. Decreased renal function slows down the excretion of drugs, thereby increasing the availability of drug in blood. Decreased liver function slows down first pass metabolism of drugs.
- decreased muscle mass
- decreased hydrochloric acid production in gastric acid
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