A nurse is caring for an adolescent who has an allergy to penicillin. Which of the following prescriptions should the nurse clarify with the provider?

As individuals age, there is a natural decline in kidney function. This can result in a reduced ability to filter and excrete medications and their metabolites from the body. The decreased kidney function can lead to a longer half-life of medications, increased drug accumulation, and an increased risk of adverse drug reactions. It is important for the nurse to adjust medication dosages and frequencies based on the individual's renal function to prevent drug toxicity.

Increased liver function: Aging is associated with a gradual decline in liver function. While there may be some individual variations, in general, liver function decreases rather than increases with age. However, changes in liver function can affect the metabolism and elimination of medications. Some medications may require dosage adjustments based on liver function, but it is not a common physiological change in older adults.

Increased metabolism: Aging is generally associated with a decrease in metabolism rather than an increase. The metabolic rate tends to slow down with age, which can affect the pharmacokinetics of medications. Slower metabolism can result in medications taking longer to be metabolized and cleared from the body, potentially leading to prolonged drug effects.

Decreased pulmonary function: While it is true that lung function decreases with age, the impact on medication administration is not as significant compared to kidney function. Medications are usually administered through non-pulmonary routes (e.g., oral, intravenous, transdermal), and decreased pulmonary function primarily affects the absorption of inhaled medications. However, certain respiratory conditions or compromised lung function may influence medication choices or require adjusted dosing.

Montelukast is a medication commonly prescribed for the management of asthma symptoms, including the prevention of asthma attacks. The recommended dosing regimen for montelukast is typically once daily, usually in the evening. This helps to provide continuous control of asthma symptoms and reduce the risk of asthma exacerbations.

Administer the medication when the toddler has an acute asthma attack: Montelukast is not intended for immediate relief during an acute asthma attack. It is a long-term control medication aimed at preventing asthma symptoms and reducing the frequency and severity of attacks. For acute asthma attacks, a short-acting bronchodilator such as albuterol is typically used.

Provide an additional dose of the medication prior to physical activity: Montelukast is not specifically indicated as a pre-exercise medication for asthma. However, in some cases, healthcare providers may prescribe it if exercise-induced bronchoconstriction is a significant concern. It is important to follow the specific instructions provided by the healthcare provider regarding medication use before physical activity.

Mix the medication in juice prior to administration: Montelukast tablets or chewable tablets should not be crushed or mixed in juice unless specifically instructed by the healthcare provider. They should be administered whole and taken with water. If the child has difficulty swallowing tablets, alternative formulations like oral granules or chewable tablets may be available.