Medication Administration Procedures

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Questions and Answers

Which condition is least likely to contribute to functional decline in hospitalized older adults?

Diminished appetite

Reduced taste sensation

Increased mobility (correct)

Polypharmacy

Which medication class is commonly associated with increased risk in older adult patients due to polypharmacy?

Benzodiazepines (correct)

Antidepressants

Statins

Antibiotics

What is a primary goal of medication reconciliation for hospitalized older adults?

Increase the number of prescribed medications

Reduce patient autonomy

Enhance polypharmacy

Identify potentially inappropriate medications (correct)

What dietary factor significantly affects older adults' nutritional status during hospitalization?

Hospital food preferences Signup and view all the answers

What common hospital-related risk contributes to delirium in older adults?

Unplanned surgeries Signup and view all the answers

Which factor is NOT a risk for complications in hospitalized older adults?

Age alone Signup and view all the answers

What nursing intervention is primarily focused on preventing adverse drug events in older adults?

Medication reconciliation Signup and view all the answers

What is an example of iatrogenesis in older adults?

Adverse drug reactions Signup and view all the answers

What behavioral factor may influence the nutritional status of older adults in a hospital setting?

Preference for certain food types Signup and view all the answers

Which intervention can effectively mitigate the risk of falls during hospitalization for older adults?

Ensuring proper sensory aids are used Signup and view all the answers

What is the primary goal of Comprehensive Geriatric Assessment (CGA)?

To improve health outcomes by addressing multiple geriatric syndromes Signup and view all the answers

Which of the following is NOT a recommended practice during medication administration?

Administer medication without educating the patient Signup and view all the answers

What common issue can arise from inaccurate or incomplete information during patient transitions?

Delayed diagnosis and duplicative services Signup and view all the answers

What is a significant risk factor for developing iatrogenesis in older adults?

Undergoing multiple transitions in healthcare settings Signup and view all the answers

Which of the following barriers significantly impact the health of older adults?

Food insecurity and limited income Signup and view all the answers

Which medication management practice can help reduce the risk of medication errors during hospital transitions?

Verifying the medication list after discharge Signup and view all the answers

What is a likely consequence of untreated hypertension in older adults?

Increased risk of cognitive decline and stroke Signup and view all the answers

During hospitalizations, what nutrition risk is frequently encountered in older adults?

Skin breakdown due to poor nutrition Signup and view all the answers

Study Notes

Medication Administration and Safety

Right patient, drug, dosage, time, route, reason, education, documentation, refusal, and evaluation are critical for safe medication administration.
Almost 50% of medication errors occur during hospital admission or discharge.
Be aware of systemic concerns such as override protocols, staffing levels, fatigue, distractions, and advocating for safety in practices.

Transitions in Healthcare

Transitions, also referred to as handoffs or transfers, involve moving a patient between providers or settings.
Around 40% of older adults undergo more than two transitions within 30 days of discharge from the hospital.
One in five adults is rehospitalized within 30 days post-discharge; a third is rehospitalized within 90 days.
Medicare incurs $15 billion in costs for readmissions, with 22% of patients experiencing at least one transition annually.

Comprehensive Geriatric Assessment (CGA)

CGA aims to mitigate iatrogenic risks, enhance early mobility, prevent delirium, and promote nutrition and family education.
Typical signs of complications include skin breakdown, eating difficulties, confusion, and falls.
Atypical presentations may involve confusion without fever and increased fall risk.

Impact of Incomplete Information

Inaccurate details can lead to delayed diagnoses, redundant medical services, hospital readmissions, and dissatisfaction among patients and providers.

Common Medical Conditions and Health Outcomes

Hypertension poses risks such as renal failure, cognitive decline, and stroke if untreated. It influences quality of life and comorbidity management.
Aimed outcomes for older adults in hospitals include avoiding complications, maintaining functional and mental status, and minimal weight loss.

Hospital Environment Risks

Rapid deconditioning occurs due to muscle weakness, atrophy, and venous stasis from prolonged immobility.
Issues such as poor oral hygiene, sleep deprivation, and nutritional decline worsen health conditions.
High-risk medications, environmental stimuli, and medical devices increase complications.

Delirium and Independence Risks

Delirium risk factors include advanced age, cognitive impairment, medical comorbidities, and sensory deficits.
Independence risk factors for older adults encompass living alone, age-related decline, and functional impairments.

Nursing Role in Care

Nurses conduct assessments focused on pain, nutrition, functional status, and medication reconciliation during older adult admissions.
Over 90% of older adults take medications, with a significant portion using five or more concurrently, increasing the risk of adverse drug events (ADEs).

Polypharmacy and Medication Safety

The Beers list provides guidelines to minimize exposure to inappropriate medications in older adults, particularly concerning benzos, diuretics, and barbiturates.
Approximately 30-60% of hospitalized older adults experience functional decline, leading to increased dependency and strain on caregivers.

Surgical risks include sensory impairments and cognitive declines, complicating informed consent processes.
Informed consent requires thorough comprehension, which nurses can help reinforce after discussions with surgeons.

Nutritional Risks in Hospitalization

Common nutritional issues for older adults include lack of appetite, decreased taste sensitivity, and poor quality of hospital food.
Delirium can impair a patient’s ability to orient themselves in time and space.

Prevention of Complications and Iatrogenesis

Iatrogenesis refers to harm resulting from medical care, including adverse drug reactions and falls.
Avoiding specific medications like barbiturates and certain analgesics is crucial to prevent unintended consequences in older adults.
Medication reconciliation must occur at all healthcare transitions to prevent errors related to medication omissions and interactions.

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Description

This quiz covers the essential steps in medication administration, including developing, comparing, and communicating medication lists. It emphasizes the importance of the right patient, drug, dosage, and the evaluation of system concerns. Understanding these principles is critical for providing safe and effective patient care.