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UTA NURS 3261 Exam 2

UTA NURS 3261 Older Adults Exam 2

Restraint risks hyperthermia, new-onset bowel and bladder incontinence, constipation, decreased appetite, pressure ulcers, muscle weakness, injury to nerves and joints, or increased risk of nosocomial infections, such as pneumonia and respiratory complications.
Percent of care provided by families in the US 80 percent
Profile of the average, informal caregiver in the US 46 years old, female, holds a full-time job and spends an average of 18 hours a week caring for her mom who lives nearby.
Stages of caregiver burnout 1. Frustration, 2. Isolation, 3. Despair
Syptoms of caregiver burnout changes in eating patterns, losing or gaining weight, irritability, impatience, and the inability to multitask.
Physical abuse acts of violence that may result in pain or injury, includes sexual
Signs of abuse unexplained fractures, welts, burns, ligature marks, unexplained STDs
Physical neglect withholding food, water, medications, hygiene, or other goods or services that are necessary for optimal functioning.
Psychological or emotional abuse diminishes the identity, dignity, and self worth of the person
Financial or material abuse when the older person’s money or property is used for financial gain by the caregiver
The Social Security Act of 1935 was designed to prevent destitution among the elderly and dependency on younger workers.
Part A pays for hospitalization, home health, hospice and some skilled nursing care.
Medicare Part B pays for office visits and outpatient services as well as other things.
Medicare Part D pays for prescription drugs
Medicaid helps pay for medications, Medicare premiums and copays, custodial care in nursing homes, as well as certain in-home services through CBA - Community-Based Alternative Care.
Death-defying societies refuse to believe that death would take anything away and believe it could be overcome.
Death-accepting societies view death as an inevitable and natural part of the life cycle.
And death-denying societies refuse to confront death, believe that death is the opposite of living and that it’s not a natural part of human existence.
Three leading causes of death in adult Americans cardiovascular disease, cancer, and cerebrovascular disease
Medicare Hospice benefits pay for for medications related to the terminal condition, nursing care, medical supervision, and medical equipment needed to treat the terminal condition.
Drugs that increase risk for falls antiepileptics, benzodiazepines
Polypharmacy Five or more drugs
Of all available nonsteroidal anti-inflammatory drugs, this drug produces the most CNS adverse effects Indomethacin (Indocin and Indocin SR)
Narcotic analgesic that causes more CNS adverse effects, including confusion and hallucinations, more commonly than other narcotic drugs. Additionally, it is a mixed agonist and antagonist. Pentazocine (Talwin)
One of the least effective antiemetic drugs, yet it can cause extrapyramidal adverse effects. Trimethobenzamide (Tigan)
Most of these drugs are poorly tolerated by elderly patients, since these cause anticholinergic adverse effects, sedation, and weakness. Additionally, their effectiveness at doses tolerated by elderly patients is questionable. Muscle relaxants and antispasmodics: methocarbamol (Robaxin), carisoprodol (Soma), chlorzoxazone (Paraflex),metaxalone (Skelaxin), cyclobenzaprine (Flexeril), and oxybutynin (Ditropan). Do not consider the extended-release Ditropan XL.
This benzodiazepine hypnotic has an extremely long half-life in elderly patients (often days), producing prolonged sedation and increasing the incidence of falls and fracture. Mediumor short-acting benzodiazepines are preferable. Flurazepam (Dalmane)
Because of its strong anticholinergic and sedation properties, this is rarely the antidepressant of choice for elderly patients. Amitriptyline (Elavil), chlordiazepoxide-amitriptyline (Limbitrol), and perphenazine-amitriptyline (Triavil)
Because of its strong anticholinergic and sedating properties, this is rarely the antidepressant of choice for elderly patients. Doxepin (Sinequan)
This is a highly addictive and sedating anxiolytic. Those using it for prolonged periods may become addicted and may need to be withdrawn slowly. Meprobamate (Miltown and Equanil)
These drugs have a long half-life in elderly patients (often several days), producing prolonged sedation and increasing the risk of falls and fractures. Long-acting benzodiazepines: chlordiazepoxide (Librium), chlordiazepoxide-amitriptyline (Limbitrol) clidinium-chlordiazepoxide (Librax), diazepam (Valium), quazepam (Doral), halazepam (Paxipam), and chlorazepate (Tranxene)
Of all antiarrhythmic drugs, this is the most potent negative inotrope and therefore may induce heart failure in elderly patients. It is also strongly anticholinergic. Other antiarrhythmic drugs should be used. Disopyramide (Norpace and Norpace CR)
May cause bradycardia and exacerbate depression in elderly patients. Methyldopa (Aldomet) and methyldopa-hydrochlorothiazide (Aldoril)
May induce depression, impotence, sedation, and orthostatic hypotension. Reserpine at doses >0.25 mg
It has a prolonged half-life in elderly patients and could cause prolonged hypoglycemia. Additionally, it is the only oral hypoglycemic agent that causes SIADH. Chlorpropamide (Diabinese)
Drugs are highly anticholinergic and have uncertain effectiveness. These drugs should be avoided (especially for long-term use). Gastrointestinal antispasmodic drugs: dicyclomine (Bentyl), hyoscyamine (Levsin and Levsinex), propantheline (Pro-Banthine), belladonna alkaloids (Donnatal and others), and clidinium-chlordiazepoxide (Librax)
May have potent anticholinergic properties. Anticholinergics and antihistamines: chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), hydroxyzine (Vistaril and Atarax), cyproheptadine (Periactin), promethazine (Phenergan), tripelennamine, dexchlorpheniramine (Polaramine)
May cause confusion and sedation. Should not be used as a hypnotic, and when used to treat emergency allergic reactions, it should be used in the smallest possible dose. Diphenhydramine (Benadryl)
Have not been shown to be effective in the doses studied. Ergot mesyloids (Hydergine) and cyclandelate (Cyclospasmol)
Doses >325 mg/d do not dramatically increase the amount absorbed but greatly increase the incidence of constipation. Ferrous sulfate >325 mg/d
Are highly addictive and cause more adverse effects than most sedative or hypnotic drugs in elderly patients. All barbiturates (except phenobarbital) except when used to control seizures
Not an effective oral analgesic in doses commonly used. May cause confusion and has many disadvantages to other narcotic drugs. Meperidine (Demerol)
Has been shown to be no better than aspirin in preventing clotting and may be considerably more toxic. Safer, more effective alternatives exist. Ticlopidine (Ticlid)
Immediate and long-term use should be avoided in older persons, since a significant number have asymptomatic GI pathologic conditions. Ketorolac (Toradol)
These drugs have potential for causing dependence, hypertension, angina, and myocardial infarction. Amphetamines and anorexic agents
Have the potential to produce GI bleeding, renal failure, high blood pressure, and heart failure. Long-term use of full-dosage, longer half-life, non–COX-selective NSAIDs: naproxen (Naprosyn, Avaprox, and Aleve), oxaprozin (Daypro), and piroxicam (Feldene)
Long half-life of drug and risk of producing excessive CNS stimulation, sleep disturbances, and increasing agitation. Safer alternatives exist. Daily fluoxetine (Prozac)
May exacerbate bowel dysfunction. Long-term use of stimulant laxatives: bisacodyl (Dulcolax), cascara sagrada, and Neoloid except in the presence of opiate analgesic use
Associated with QT interval problems and risk of provoking torsades de pointes. Lack of efficacy in older adults. Amiodarone (Cordarone)
Causes more sedation and anticholinergic adverse effects than safer alternatives. Orphenadrine (Norflex)
May cause orthostatic hypotension. Guanethidine (Ismelin), Guanadrel (Hylorel)
Potential for renal impairment. Safer alternatives available. Nitrofurantoin (Macrodantin)
Potential for hypotension, dry mouth, and urinary problems. Doxazosin (Cardura)
Potential for prostatic hypertrophy and cardiac problems. Methyltestosterone (Android, Virilon, and Testrad)
Greater potential for CNS and extrapyramidal adverse effects. Thioridazine (Mellaril), Mesoridazine (Serentil)
Potential for hypotension and constipation. Short acting nifedipine (Procardia and Adalat)
Potential for orthostatic hypotension and CNS adverse effects. Clonidine (Catapres)
Potential for aspiration and adverse effects. Safer alternatives available. Mineral oil
CNS adverse effects including confusion. Cimetidine (Tagamet)
Potential for hypertension and fluid imbalances. Safer alternatives available. Ethacrynic acid (Edecrin)
Concerns about cardiac effects. Safer alternatives available. Desiccated thyroid
CNS stimulant adverse effects. Amphetamines (excluding methylphenidate hydrochloride and anorexics)
Evidence of the carcinogenic (breast and endometrial cancer) potential of these agents and lack of cardioprotective effect in older women. Estrogens only (oral)
Four issues affecting the health of older persons lack of resources; scarcity of providers; financial barriers; and cultural barriers and biases
Created by: camellia