Question

You are the emergency department nurse caring for Mr. Jones a 74-year- old man who sustained a fracture to his right femur and left ankle when he fell off the roof of his two-story home. Your patient is complaining of pain that is a 9 on a scale of 0 to 10. You note that he has no medications ordered for pain. 1. Which route of administration for the medication might be best for this patient and why? 2. What type of dosage adjustment would you expect for this patient 3. List special considerations of absorption, metabolism and elimination that are related to Mr. Jones.

Answer 1

1.A pain of 9 in a pain scale of 0 to 10 indicates severe pain which means the patients needs a medication which can act fastly.Injections by intravenous route is the best route of administration to relieve or control pain at the earliest because th medication enters the bloodstream directly

2.The dosage adjustment has to be done based on the renal function of the patient .The initial dose can be a loading doses followed by gradual tapering of the doses and then stopping the medication.

3.By the age of 74 the renal function decreases due to physiological process and in addition if patient has any medical complaints or on any medications. The metabolism of a drug after it reaches the organs like liver are slowed down due to old age leading to decrease in metabolic rate and absorption. The decreased renal function may lead to decreased elimination of the drug resulting in accumulation of the drug in th body and causing discomfort. So it has to be calculated on the basis of glomerular filtration rate.