The nurse caring for a 74-year-old man who has just returned to the medical-surgical unit following surgery for a total knee replacement received report from the PACU

Question

Part of the report had been passed on from the pre-operative assessment where the patient stated that he has "been confused in the past when he takes pain medications." What does the nurse realize that the elderly may do?
A) The elderly may require lower doses of medication and are easily confused with new medications.
B) The elderly may have altered absorption and metabolism, which prohibits the use of opiates.
C) The elderly may be confused following surgery, and that is related to normal aging and unrelated to the medication.
D) The elderly may require a higher initial dose of pain medication followed by a tapered dose.

Answer 1

Ans: A
Feedback: The elderly often require lower doses of medication and are easily confused with new medications. The elderly have slowed metabolism and excretion, and, therefore, the elderly should receive a lower dose of pain medication given over a longer period time, which may help to limit the potential for confusion. Unfortunately, the elderly are often given the same dose as younger adults, and the resulting confusion is attributed to other factors like environment. Option B is incorrect; the elderly may have altered absorption and metabolism, but the use of lower dose opiates is encouraged for pain. Option C is incorrect; confusion following surgery is never normal. Option D is incorrect; with the elderly, we should start medication at a low dose and slowly increase the dose until the pain is managed.