Questions and Answers
Which condition is least likely to contribute to functional decline in hospitalized older adults?
Which medication class is commonly associated with increased risk in older adult patients due to polypharmacy?
What is a primary goal of medication reconciliation for hospitalized older adults?
What dietary factor significantly affects older adults' nutritional status during hospitalization?
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What common hospital-related risk contributes to delirium in older adults?
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Which factor is NOT a risk for complications in hospitalized older adults?
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What nursing intervention is primarily focused on preventing adverse drug events in older adults?
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What is an example of iatrogenesis in older adults?
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What behavioral factor may influence the nutritional status of older adults in a hospital setting?
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Which intervention can effectively mitigate the risk of falls during hospitalization for older adults?
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What is the primary goal of Comprehensive Geriatric Assessment (CGA)?
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Which of the following is NOT a recommended practice during medication administration?
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What common issue can arise from inaccurate or incomplete information during patient transitions?
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What is a significant risk factor for developing iatrogenesis in older adults?
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Which of the following barriers significantly impact the health of older adults?
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Which medication management practice can help reduce the risk of medication errors during hospital transitions?
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What is a likely consequence of untreated hypertension in older adults?
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During hospitalizations, what nutrition risk is frequently encountered in older adults?
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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 and Consent Considerations
- 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.
