A 65-year-old with renal insufficiency
Explanation:
Many medications are excreted through the kidneys; therefore, the patient with the highest risk for drug toxicity is the patient with renal insufficiency.
An older adult with chronic diarrhea has increased gastric motility, which may decrease the absorption of the medication and not increase the risk of toxicity.
A BMI of 22.6 is within the normal range; therefore, the client is not at as high risk as someone who is underweight or overweight.
Vascular changes do happen with diabetes mellitus, which may increase the risk for drug toxicity. Because the client has been diagnosed with diabetes for only 2 years, vascular changes are usually not significant enough to put the client at a higher risk than someone with known renal insufficiency.
The nurse is providing medication instructions to an older client who is taking digoxin (Lanoxin) daily for atrial fibrillation. The nurse notes that which age-related body change could place the client at risk for digoxin toxicity?
1. Decreased muscle strength and loss of bone density
2. Decreased cough efficiency and decreased vital capacity
3. Decreased salivation and decreased gastrointestinal motility
4. Decreased lean body mass and decreased glomerular filtration rate
Answer: 4 Older client is at risk of toxicity because of decreased body mass and GFR, the client's kidneys do not excrete the heart medication as well as a younger patient's kidneys. 1 is incorrect because muscle strength and bone density would not affect drug metabolism. 2 is incorrect because lung function would also not impact drug metabolism. 3 is incorrect because slower gastric motility would not impact the overall amount of drug absorbed, it may just slow down the absorption.
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