VCS Safety: Polypharmacy 3.0 Case Study Test

A nurse is reviewing the lab results of an older adult client who is taking multiple medications. Which of the following findings could impact the client's ability to distribute medication throughout their system?

Albumin 3.0 g/dL

Rationale: When a client is taking multiple medications, especially medications that are protein-bound, an albumin level that is bellow the expected reference range impacts the client';s ability to distribute medications throughout their system. The poor distribution decreases the effectiveness of the medication and leads to low serum medication levels. Medication toxicity can be the end result of a medication dosage adjustment based on a low serum medication level.

A nurse is reviewing the medication list of an older adult client upon admission and notes that they are taking fluoxetine for depression. The nurse should identify that fluoxetine can increase the effects of which of the following medications that is also on the client's list?

Warfarin

Rationale: The nurse should recognize that the client's antidepressant medication, fluoxetine, can increase the effects of the anticoagulant medication, warfarin, which could lead to a potential toxicity.

A nurse is admitting a client who is scheduled for surgery. The nurse is completing medication reconciliation with the client's new admission medication prescriptions. For which of the following situations should the nurse plan to repeat the medication reconciliation process?

The client returns to the unit from the surgical suite

Rationale:

It is important for the nurse to ensure that medication reconciliation is repeated when a client is transferred from one level of care to another, even within the same facility. This process addresses omissions, interactions, and duplications that can lead to complications from polypharmacy in the older adult client.

A nurse is providing discharge teaching to an older adult client who is taking multiple medications. Which of the following information should the nurse include in the teaching?

"You should consult your provider before taking an herbal supplement."

Rationale:

The nurse should instruct the client to discuss taking any new medications, including herbal supplements , with their provider. This is especially true for the older adult client who is taking multiple medications, due to the potential for adverse reactions and medication interactions.

A nurse is reviewing the medication list of a client and notes that the client is taking simvastatin for hypercholesterolemia as well as multiple herbal supplements. Which of the following supplements indicated on the client's medication list can decrease the effect of simvastatin?

St. John's Wort

Rationale:

St. John's wort can decrease the effect of simvastatin. Therefore, the nurse should notify the provider that the client is taking this medication and herbal supplement combination.