Prior to administering pain medication to an adult postoperative client, what information should the practical nurse (PN) obtain? (Select all that apply.)

Choice A rationale:

This is the correct answer. Older adults often experience decreased kidney function as a normal part of aging. Medications that are excreted primarily by the kidneys may require dosage adjustments to prevent potential toxicity.

Choice B rationale:

Increased liver function is not a typical physiological change in older adults. Liver function tends to decrease with age, which can affect the metabolism and clearance of certain medications.

Choice C rationale:

Increased metabolism is not a common physiological change in older adults. Metabolic rate tends to decrease with age, which can affect the metabolism of drugs.

Choice D rationale:

While pulmonary function may decrease with age, it is not the primary physiological change to consider when administering medications to older adults. Kidney function is a more critical factor in medication dosing for this population.

Choice A rationale:

The nurse should encourage the client to be assertive. Dependent Personality Disorder is characterized by a pervasive and excessive need to be taken care of, leading to submissive and clinging behavior. One of the treatment goals is to help the client develop assertiveness skills to reduce their dependence on others. Encouraging assertiveness allows the client to express their needs and make decisions for themselves, which is an essential aspect of their therapeutic journey toward independence.

Choice B rationale:

Assuming responsibility for making the client's decisions would not be appropriate. It would further reinforce the client's dependent behavior and hinder their progress towards independence. The goal of therapy is to promote autonomy and self-reliance, not to perpetuate dependency.

Choice C rationale:

Maintaining a verbal no-harm contract with the client may be necessary in some cases, especially if the client exhibits self-harming behaviors. However, it is not a primary teaching point when educating the caregiver about managing a client with Dependent Personality Disorder. The focus should primarily be on helping the client develop assertiveness and self-reliance.

Choice D rationale:

Limiting the client's social interactions is not an appropriate intervention. Social support can be beneficial for individuals with Dependent Personality Disorder, as it can help them build self-confidence and reduce their excessive reliance on one individual. Isolating the client would not be in their best interest.