A nurse is administering medications to a client who is 65 years old. The nurse knows that older adults are at increased risk for adverse drug reactions due to which of the following physiological changes?

Increased renal clearance

Increased plasma protein levels.

Decreased liver function.

Decreased blood-brain barrier.

Answer and Explanation

The Correct Answer is C

The correct answer is C.

Decreased liver function. Older adults are at increased risk for adverse drug reactions due to various physiological changes that affect the absorption, distribution, metabolism and excretion of drugs. One of these changes is the reduction in liver blood flow, size, drug-metabolizing enzyme content and function. This can result in slower or decreased metabolism of drugs, leading to higher plasma concentrations and increased risk of toxicity.

Choice A is wrong because older adults have decreased renal clearance, not increased. This means that drugs that are eliminated by the kidneys may accumulate in the body and cause adverse effects.

Choice B is wrong because older adults have decreased plasma protein levels, not increased. This means that drugs that are bound to plasma proteins may have higher free fractions and increased pharmacological effects.

Choice D is wrong because older adults have increased permeability of the blood-brain barrier, not decreased. This means that drugs that cross the blood-brain barrier may have enhanced central nervous system effects in older adults.

Normal ranges for liver function tests vary depending on the laboratory and the method used, but some common values are:.

• Alanine aminotransferase (ALT): 7-55 U/L.

• Aspartate aminotransferase (AST): 8-48 U/L.

• Alkaline phosphatase (ALP): 45-115 U/L.

• Total bilirubin: 0.1-1.2 mg/dL.

• Albumin: 3.5-5 g/dL.

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Correct Answer is B

Explanation

The correct answer is B. Decreased stroke volume.

Stroke volume is the amount of blood pumped by the left ventricle of the heart in one contraction.

The contractile strength of the myocardium determines how much blood is ejected with each beat.As people age, the myocardium becomes less elastic and less responsive to catecholamines, which can reduce the contractile force and lower the stroke volume.

Choice A is wrong because increased heart rate is not related to the decreased contractile strength of the myocardium, but rather to the decreased responsiveness of the baroreceptors, which regulate blood pressure.Older adults may have higher resting heart rates and lower maximum heart rates than younger adults.

Choice C is wrong because increased cardiac output is not related to the decreased contractile strength of the myocardium, but rather to the increased blood volume and cardiac workload that may occur with aging.Cardiac output is the product of stroke volume and heart rate, so a lower stroke volume would tend to decrease cardiac output.

Choice D is wrong because decreased peripheral resistance is not related to the decreased contractile strength of the myocardium, but rather to the decreased elasticity and increased stiffness of the arterial walls that may occur with aging.

Peripheral resistance is the opposition to blood flow caused by friction between the blood and the vessel walls.A higher peripheral resistance would increase the afterload on the heart and reduce the stroke volume.

Normal ranges for stroke volume are 60 to 100 mL/beat for men and 50 to 90 mL/beat for women.

Normal ranges for heart rate are 60 to 100 beats per minute for adults.

Normal ranges for cardiac output are 4 to 8 L/min for adults.

Normal ranges for peripheral resistance are 800 to 1200 dynes/sec/cm-for adults.

A. “You may experience dizziness when you stand up quickly.”. B. “Your blood pressure may drop when you are resting.”. C. “Your heart may beat faster when you exercise.”. D. “Your blood vessels may become stiffer and narrower.”. E. “Your heart may skip some beats or have extra beats.”.

Correct Answer is ["A","D","E"]

Explanation

The correct answer is A, D, and E.

Here is why:.

A. “You may experience dizziness when you stand up quickly.” This is true because aging causes the arteries and arterioles to become less elastic and less able to adjust the blood pressure quickly when the posture changes.This can lead to a drop in blood pressure when standing up, which can cause dizziness or fainting.

D. “Your blood vessels may become stiffer and narrower.” This is true because aging causes the walls of the arteries and arterioles to become thicker and stiffer, which reduces their compliance and increases the resistance to blood flow.This can lead to high blood pressure, atherosclerosis, and other cardiovascular diseases.

E. “Your heart may skip some beats or have extra beats.” This is true because aging causes changes in the electrical system of the heart, which can result in arrhythmias such as atrial fibrillation, premature ventricular contractions, or sinus bradycardia.These can cause irregular heartbeats that may be felt as palpitations or skipped beats.

B. “Your blood pressure may drop when you are resting.” This is false because aging does not cause a decrease in blood pressure at rest.

In fact, aging tends to increase the systolic blood pressure (the pressure when the heart contracts) due to the stiffening of the arteries.The diastolic blood pressure (the pressure when the heart relaxes) may remain normal or decrease slightly, resulting in a widened pulse pressure (the difference between systolic and diastolic pressures).

C. “Your heart may beat faster when you exercise.” This is false because aging does not cause an increase in heart rate during exercise.

In fact, aging tends to decrease the maximum heart rate that can be achieved during exercise due to the reduced responsiveness of the heart to adrenergic stimuli.The older heart also takes longer to recover after exercise.

Normal ranges for blood pressure are less than 120/80 mmHg for adults of any age.Normal ranges for heart rate are 60-100 beats per minute for adults of any age, but the maximum heart rate decreases with age according to the formula 220 minus age.

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A nurse is administering medications to a client who is 65 years old. The nurse knows that older adults are at increased risk for adverse drug reactions due to which of the following physiological changes?

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who is 75 years old. Which of the following findings is most likely related to the decreased contractile strength of the myocardium in older adults?

Correct Answer is B

Explanation

A nurse is teaching a group of older adults about the effects of aging on the cardiovascular system. Which of the following statements should the nurse include? (Select all that apply.).

Correct Answer is ["A","D","E"]

Explanation

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