Pharmacology in Pediatrics and Geriatrics

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Questions and Answers

What is the primary cause of medication accumulation leading to toxicity in older adults?

Enhanced metabolic activity
Decreased kidney and liver function (correct)
Decreased body water content
Increased blood protein-binding sites

Which of the following medications is likely to cause metabolic tolerance?

Beta-blockers
Antidepressants
Barbiturates (correct)
Morphine

What factor contributes to the increased effects of medications on the CNS in neonates?

Reduced liver size
Higher body temperature
Fully developed blood-brain barrier
Underdeveloped blood-brain barrier (correct)

Which action should a nurse take to promote medication adherence in children?

Offer clearly-marked containers (D) Signup and view all the answers

What leads to pharmacodynamic tolerance in patients taking morphine over time?

Reduced responsiveness to the medication (C) Signup and view all the answers

What is a significant consideration for administering medications to children?

Dosages must be accurate for weight or BSA (D) Signup and view all the answers

What describes a situation where prior tolerance to one medication affects the response to another similar medication?

Cross-tolerance (A) Signup and view all the answers

Which factor increases the effectiveness of water-soluble medications in patients with higher body water content?

Dilution of medications (B) Signup and view all the answers

What is a recommended method for disposing of medications that are no longer needed?

Mix with an undesirable substance and dispose in the household trash (A) Signup and view all the answers

Which of the following is a physiologic change with aging that affects pharmacokinetics?

Decreased hepatic enzyme function (A) Signup and view all the answers

What should clients be advised to do regarding adherence to medication regimens?

Set up a daily calendar for medication times (C) Signup and view all the answers

What impact do gastrointestinal changes in older adults have on medication absorption?

Slower absorption due to decreased gastric emptying time (D) Signup and view all the answers

What is a common limitation for intravenous medication administration?

Limited sites exist for IV medication administration (D) Signup and view all the answers

Which medication-related consideration is particularly important for pregnant clients?

Any medication can affect the fetus adversely (B) Signup and view all the answers

What assistance can clients seek to promote adherence to medication regimens?

From friends or family for reminders (B) Signup and view all the answers

What change occurs in the cardiovascular system of older adults affecting pharmacotherapy?

Decreased blood flow through the cardiovascular system (D) Signup and view all the answers

Why is it important to base pediatric medication dosages on body surface area (BSA)?

It accounts for variations in body fat distribution. (C) Signup and view all the answers

What factor makes newborns and infants especially sensitive to medications?

Immature liver and kidney function. (D) Signup and view all the answers

In what way do sex differences affect medication response?

Females respond differently due to a higher body fat proportion. (A) Signup and view all the answers

Which of the following can alter the metabolism of certain medications in individuals?

Genetic factors such as missing enzymes. (A) Signup and view all the answers

What impact does decreased gastric acid production have on medication?

It can lead to greater medication toxicity. (A) Signup and view all the answers

What is a characteristic of the blood-brain barrier in newborns?

It presents a higher permeability, making newborns sensitive to CNS-affecting medications. (B) Signup and view all the answers

How does body weight affect medication dosing in children?

Medication dosages are often based on body weight for accurate dosing. (B) Signup and view all the answers

Which of the following is a common characteristic of topical medication absorption in children?

Increased absorption due to greater blood flow to thinner skin. (B) Signup and view all the answers

Why are live-virus vaccines contraindicated during pregnancy?

They may cause teratogenic effects. (A) Signup and view all the answers

What is the safest recommendation for medication administration to lactating clients?

Give medications immediately after breastfeeding. (D) Signup and view all the answers

What is a key nursing intervention when managing a pregnant client’s medication therapy?

Monitor for therapeutic and adverse effects. (B) Signup and view all the answers

What should be considered when prescribing medications to clients of reproductive potential?

Some medications can affect fetal harm and reproductive ability. (D) Signup and view all the answers

Which of these medications should lactating clients avoid?

Medications with extended half-lives. (D) Signup and view all the answers

How can adverse effects be managed in pregnant clients receiving medication?

Notify the provider of adverse effects immediately. (C) Signup and view all the answers

What is the recommended approach for starting medication therapy in pregnant women?

Begin with the lowest possible dose. (D) Signup and view all the answers

What is an important component of a complete medication history for pregnant clients?

Over-the-counter medications, illicit drugs, and herbal supplements. (A) Signup and view all the answers

Which vaccines are contraindicated during pregnancy due to containing live viruses?

Rubella vaccine (D) Signup and view all the answers

What type of influenza vaccine is recommended for pregnant clients during influenza season?

Inactivated influenza vaccine (A) Signup and view all the answers

How does reduced hepatic function in older adults affect medication metabolism?

It prolongs the effects of medications. (C) Signup and view all the answers

Which of the following factors would likely require lower dosages of medications in older adults?

Reduced hepatic function (C) Signup and view all the answers

What is a common effect of the first-pass effect on medication?

It results in faster metabolizing and decreased effect. (B) Signup and view all the answers

When should a client notify their primary health provider regarding medication use?

When they experience side effects or adverse effects. (A) Signup and view all the answers

What is a significant consideration when providing care for clients with substance-related withdrawal?

Implementing effective symptom management. (C) Signup and view all the answers

What common misunderstanding might clients have regarding medication interactions?

Interactions only occur with other prescription medications. (C) Signup and view all the answers

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Study Notes

and Children

Dosage adjustment is crucial for children due to immature organs (liver, kidneys), altered gastric pH, and blood-brain barrier development
Dosage is calculated based on body weight or body surface area (BSA)
Newborns and infants are especially sensitive to CNS-affecting medications

Pharmacology

Pharmacology and Older Adults

Reduced liver and kidney function in older adults can lead to medication accumulation and toxicity
Decreased gastric motility and slower gastric emptying slow medication absorption
Lower blood flow to liver and kidney may impact medication efficacy and toxicity
Increased gastric pH affects drug absorption and efficacy

Nursing Actions When Administering Medications to Children

Most medications are not specifically tested on children
Initial pediatric dosages are approximations
Adult medication forms may require dilution, calculation, and preparation for children
Limited sites exist for IV medication administration, requiring specific knowledge and expertise

Promoting Adherence to Medication Regimens

Provide clear and concise instructions, both verbally and in writing
Ensure accurate dosages are provided based on weight or BSA
Provide appropriate dosage forms for children (e.g., liquid forms for those struggling with pills)
Use clearly marked containers that are easy to open
Assist with daily medication calendars and pill containers

Pharmacology and Pregnancy, Lactation, and Reproductive Potential

Medication taken during pregnancy can affect the fetus; most medications are potentially harmful
Live-virus vaccines are contraindicated in pregnancy due to teratogenic effects
The inactivated influenza vaccine is recommended for pregnant women during influenza season
Most medications taken by lactating women enter breast milk and may be harmful to the infant
Medications with long half-lives, sustained-release formulations, or those harmful to infants should be avoided during lactation
Give safe medications immediately after breastfeeding to minimize medication concentration in the following feeding
Use the lowest effective dosage for the shortest possible time for medications given during lactation

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