Pain in the a**
Techniques to assess an elderly patients who cannot speaks pain
Whate are observe body tensnes or posturing. Listen four sounds of groaning and facial expresions. Notice for signs of not sleeping.
Which patient are more vulnerable to get digoxin toxicity.
patient with lo potassium levels, deceased kidney function, potassium wasting diuretics,
Name drugs that can cause anticholinergics effects
amytriptiline, ranitidine, diphenhydramine
Primary organs of medication clearance
kidneys and liver
decreased intracellular fluid volume and decreased albumin levels
Medication class with the lead cause of emergency room visits.
Anticoagulants (warfarin, apixaban, dabigatran, edoxaban, rivoroxaban)
ADR
adverse drug reaction
Alternative techniques for poor sleep to avoid sedative/relaxants
Labs that reflect proper functioning to eliminate drugs appropriately
BUN, Cr, GFR, AST, ALT
Orders that should be questioned related to popper dosing.
Aminoglycosides with low therapeutic indexs.
Understand how to manipulate doses based off to lab levels, adverse reactions and effective treatment
Use Gentamycin for an example
Most common reasons insulin diabetic elderly patients go to the hosptial.
Not eating or adjusting dose with lowered appetite
What are some side effects and signs of anticholinergics
Urinary Retention
Dry mouth
Burred vision
Drowsiness
What can macrobid,
vancomycin,
fluoroquinolones,
and aminoglycosides cause.....
Bad with lowered creatine clearance
tight therapeutic control and monitoring of kidney function
neuro effects and c.dff
nephrotoxic
Adverse reactions occur more frequently in older adults due to....
Consumption of numerous drugs r/t to multiple chronic illnesses
Drugs being orders by multiple doctors.
Self medicating with OTC preparations
CNS changes in geriatrics caused by anticholinergics
Agitations
Confusion
Disorientation
Poor attention
Hallucinations
Psychosis
Rigidity of the upper and lower extremities.
Fever
Hyptension
Tachycardai
Most common side effects in the elderly that take opiates
Falls
Bleeding r/t blood thinners
Delerium/confusion
Overdose
Symptoms to be monitored on a post op patient on many medications
Changes in LOC, confusion, urinary hesitancy, hypotension
This medication should be used carefully or not at all due to it causing neurotoxicity and delirium.
Medications in older adults are absorbed slower is primarily because of what?
Increased pH of gastric secretions
What would you check and hold digoxin for
Heart rate, holding for bpm <60
What does dry as a bone, red as a beet, hot as a hare, and blind as a bat mean.?
Inhibited secretions
Flushing r/t absence of sweating
Temp rise r/t absence of sweating
Paralysis of the ciliary muscles and dilated pupils
The definition of AKI
Increased CR x 0.3x within 48 hours
OR
Increased CR x 1.5x baseline presumed to be within 7 days
OR
Urine volume <0.5 ml/kg/h for 6 hours not related to normal input
True things about Beers Criteria
I lists meds that should be used in caution with elderly
It list specific drug drug interactions now to harm elderly.
Lists medications that may need to be adjusted in patients with impaired kidney function