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Increased renal excretion of protein-bound drugs – Aging is typically associated with decreased, not increased, renal function. Slower elimination can lead to higher drug levels in the blood, but the concern is drug accumulation, not increased excretion.

More alkaline gastric pH, resulting in more adverse effects – Older adults often have a less acidic stomach environment, which can alter drug dissolution and absorption. while this may influence the onset or extent of absorption, it is not the primary reason why journaling adverse effects is emphasized for this population.

Less adipose tissue to store fat-soluble drugs – In older adults, there is typically more adipose tissue compared to lean muscle mass, not less. Increased fat stores can prolong the half-life of fat-soluble drugs, but this is unrelated to why the nurse emphasizes journaling adverse effects in this scenario.

Nonsteroidal antiinflammatory drugs (NSAIDs) – NSAIDs primarily affect the gastrointestinal tract and kidneys, and while they can contribute to fluid retention or increase blood pressure, they are not a common cause of sudden drops in blood pressure upon standing.

Cardiac glycosides – Drugs like digoxin can cause dizziness or vision changes due to bradycardia or toxicity, but they do not directly cause orthostatic hypotension. If dizziness is related to these medications, it is usually due to altered heart rate or rhythm, not a positional drop in blood pressure.

Anticoagulants – These drugs reduce clotting ability and increase bleeding risk but have no direct effect on blood pressure regulation. Dizziness in patients on anticoagulants may result from anemia due to bleeding, but not from position changes causing hypotension.

Ask the patient what medications he takes at home – Older adults experiencing confusion may have unreliable recall of medication details, increasing the risk of omissions or inaccuracies.

Ask the patient's wife what medications he takes at home – While family members can provide helpful information, they may not know exact dosages, strengths, or updated medication changes, leading to incomplete data.

Contact the patient's pharmacy for a list of the patient's current medications – A pharmacy list can be useful but may not reflect over-the-counter drugs, herbal supplements, or prescriptions filled at other pharmacies.

Speak only to the parents about the medication plan – This approach ignores the adolescent’s need for involvement and control over their health decisions, which can result in resistance or poor adherence.

Provide minimal details to avoid overwhelming the patient – Limiting information deprives the adolescent of the knowledge necessary to manage their own health safely and can create confusion or mistrust.

Give a written schedule without further discussion – Written instructions alone cannot address questions, correct misconceptions, or ensure understanding. Interactive discussion is essential for safe use.

Increased total body water – Older adults typically have decreased, not increased, total body water, which primarily affects water-soluble drugs rather than lipid-soluble drugs like benzodiazepines.

Increased plasma albumin levels – Plasma albumin levels often decrease with age or chronic illness, especially affecting protein-bound drugs. Higher albumin levels are uncommon in older adults and would not explain prolonged sedation.

Increased renal clearance – Renal clearance usually declines with aging due to reduced glomerular filtration rate. Even if renal clearance increased, benzodiazepines are metabolized mainly by the liver, not eliminated unchanged by the kidneys.