NUR209/ NUR 209 (2024/2025) Questions with Correct Verified Answers ,GRADED A
NUR209/ NUR 209 (2024/2025) Questions with Correct Verified Answers ,GRADED A
NUR209/ NUR 209 (2024/2025) Questions with Correct Verified Answers ,GRADED A
NUR209/ NUR 209 (2024/2025) Questions with Correct Verif...
NUR209/ NUR 209 (2024/2025)
Questions with Correct Verified
Answers ,GRADED A
Leading cause of injury in older adults? - ANS ✔Falls!
- pts who fall are more likely to be admitted to long term care
- a hx of falls is a big predictor for future falls!!
Cataract Surgery: indications - ANS ✔- must be 20/40 or worse,
- and sx like glare, halo, and photosensitivity
Cataract Surgery: complications - ANS ✔infection, retinal detachment,
corneal edema
Cataract Treatment - ANS ✔- prevent with multivitamins, antioxidant
foods, supplements
- Surgery (vision must be 20/40 or worse, and sx like glare, halo, and
photosensitivity)
- Complication: infection, retinal detachment, corneal edema
Presbyopia - ANS ✔Farsightedness as a result of aging
- poor accommodation
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- hardening of the crystalline lens (nuclear sclerosis)
- atrophy
- decreased photoreceptors in the retna
Pharmacokinetics - ANS ✔the body's effect on the drug
absorption, distribution, metabolism, and excretion
how is absorption different in geriatric patients - ANS ✔-certain
diseases and medications can cause increased GI motility (absorbs less
drug) or increase motility (sits there and is over-absorbed)
- decreased perfusion of blood to GI system, decr peristalsis
- antacid and PPI drugs = increased gastric pH (more basic( which
affects absorption of other drugs
- atrophy of GI tract = decr surface area &villi for absorption
- less active transporters, altering absorption
- *absorption SPEED is SLOWED, but the total amount absorbed is
unchanged from young*
How is distribution different in geriatric pts - ANS ✔- older pts have
more fat and less lean mass = fat soluble drugs have more volume to
distribute over = decr serum levels
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- old ppl have less total body water = hydrophilic drugs have less
volume to distribute over, causing incr serum level
- old pts have decreased serum albumin levels = drugs that bind to
proteins will have less to bind to = increased free floating active drugs
in blood
How is metabolism different in geriatric pts - ANS ✔- Phase 1
metabolism (cytochrome P450) system is used to metabolize drugs, and
decreases with age.
The P450 system can be inhibited or activated by other drugs/food
- individuals can have genetic polymorphisms = fast ultra-
metabolizers
- First pass/Phase 1 metabolism (activates the drug): decr by 1% per
year
- Phase 2 (hepatic/conjunction) metabolism = for inactivating drugs
mostly
How is excretion different in geriatric pts - ANS ✔- aging = decreased
RENAL FUNCTION (decr is mass and perfusion of kidney)
- low creatinine is a less reliable indicator of poor renal function in
adults bc they have decr muscle mass
- increased half life for water soluble drugs
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Creatinine Clearance Formula - ANS ✔1.2 (140-age) (weight in kg)
______________________________________
Serum creatinine (umol/L)
(for women, replace 1.2 with 0.85)
Pharmacodynamics - ANS ✔How the drug affects the body
How is the CARDIOVASCULAR system different in geriatric pts - ANS
✔- decr baroreceptors sensitivity (therefore = postural hypotension
caused by antihypertensives)
- decr sensitivity and number of beta-adrenoreceptors (therefore decr
vasodilation/constriction when in need)
- more likely to have prolonged QT interval (risk of arrhythmia and
even vfib/MI)
How is the RENAL system different in geriatric pts - ANS ✔- incr risk of
dehydration, hypovolemia, and electrolyte imbalances (esp if given
diuretics)
- worse kidney function/perfusion = diuretics don't reach the site of
action on kidney very well = may need a BIGGER diuretic dose
Geriatric pts have ___creased sensetivity to CNS drugs - ANS
✔increased
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