Which age-related physiological change puts a client at higher risk for adverse medication complications?

The client with a labored respiratory rate of 28 should be seen first because this indicates respiratory distress, which is a life-threatening condition that requires immediate intervention. Respiratory rate is one of the vital signs that are used to assess the severity of a patient’s condition and to triage them accordingly. A normal respiratory rate for an adult is 12 to 20 breaths per minute.

Choice A is wrong because a large laceration on the left scapula is not as urgent as respiratory distress.

A laceration is a wound that involves a cut or tear in the skin, which may cause bleeding, pain, and infection. However, it can be managed with wound care and suturing in the urgent care center.

Choice B is wrong because a compound fracture of the right tibia is not as urgent as respiratory distress.

A compound fracture is a fracture that breaks through the skin, which may cause bleeding, pain, infection, and nerve or blood vessel damage. However, it can be stabilized with splinting and dressing in the urgent care center before transferring to a hospital for further treatment.

Choice C is wrong because being unable to breastfeed a 4 week old is not as urgent as respiratory distress.

Breastfeeding difficulties may be caused by various factors, such as poor latch, low milk supply, sore nipples, or mastitis. However, they can be managed with education, support, and medication in the urgent care center.

This is because older adults have a reduced ability to excrete drugs and their metabolites through the kidneys, which can lead to drug accumulation and toxicity. Decreased renal function can also affect the pharmacokinetics and pharmacodynamics of many drugs, altering their absorption, distribution, metabolism, and elimination.

Choice A is wrong because reduced muscle mass does not directly affect drug metabolism or clearance, although it may affect the volume of distribution of some drugs that are highly protein-bound or lipophilic.

Choice C is wrong because slowed gastrointestinal motility does not increase the risk of adverse drug events in older adults, although it may affect the rate and extent of drug absorption.

Choice D is wrong because thinning of the layers of the skin does not affect drug metabolism or clearance, although it may increase the risk of skin infections or injuries.