Question

. The nurse knows the older adult has an increased risk for drug toxicity. Which of the following contributing factors increase the risk for drug toxicity? A. Impaired renal function B. Decrease in blood flow to the kidneys C. Polypharmacy D. Urinary incontinence E. Possibility of multiple chronic conditions requiring medications F. Using many physicians and lack of communication between physicians

Short answer

The factors contributing to an increased risk for drug toxicity in older adults include impaired renal function, decrease in blood flow to the kidneys, polypharmacy, possibility of multiple chronic conditions requiring medications, and using many physicians with a lack of communication between them.

Step-by-step solution

Identify Contributing Factors for Drug Toxicity

First, we must identify which factors increase the risk of drug toxicity in older adults. Drug toxicity can be influenced by the body's ability to metabolize and excrete the drug. Considerations include organ function, medication management, and healthcare system complexities.

Analyze Each Option

Evaluate each option to determine whether it directly contributes to the increased risk of drug toxicity. Options that affect medication metabolism or excretion, polypharmacy (multiple medications), or healthcare management factors are all relevant.

Determine Correct Responses

Based on the evaluation, choices that relate to organ function (A and B), medication management (C and E), and healthcare system complexities (F) would increase the risk for drug toxicity. Urinary incontinence (D) is not directly related to drug toxicity.

Key concepts

Impaired Renal Function

Understanding the implications of impaired renal function in older adults is pivotal in assessing the risk of drug toxicity. The kidneys have a profound role in clearing medications from the body. As we age, kidney function naturally declines, which can lead to an accumulation of drugs in the body and increase the risk of toxicity. This decline in renal function means that drugs are not excreted as efficiently, and dosages may need to be adjusted accordingly.

It's essential for healthcare providers to regularly monitor kidney function in older patients, especially when prescribing medications that are cleared by the kidneys. Tests like serum creatinine and creatinine clearance can provide insights into how well the kidneys are functioning. Understanding the difference between acute kidney injury and chronic kidney disease is also key, as both have different implications for medication management.

Polypharmacy

The term polypharmacy refers to the use of multiple medications concurrently and is a common issue among older adults, particularly those with multiple chronic conditions. The more medications an individual takes, the higher the risk for drug interactions, side effects, and, consequently, drug toxicity.

Medication reviews should be a routine process, involving a thorough examination of all the drugs a person is taking to ensure each one is necessary, dosed appropriately, and not interacting negatively with the others. It's also worth considering non-pharmacological alternatives when possible. Reducing polypharmacy can lower the chance of adverse drug reactions and improve overall medication compliance. Care coordination between different healthcare providers is a crucial step in managing polypharmacy effectively.

Medication Management for Chronic Conditions

For older adults managing chronic conditions, medication management becomes a critical aspect of care. The goal is to optimize therapeutic outcomes and enhance a patient's quality of life while minimizing the risks associated with long-term medication use, such as drug toxicity.

Effective medication management may entail developing a personalized medication plan, regular monitoring for effectiveness and side effects, and making adjustments as necessary. Patient education is vital, as understanding how to take medications correctly and the importance of adherence can prevent complications. Additionally, involving family members or caregivers can provide additional support to the patient, ensuring that the medication regimen is followed as prescribed.