An older adult patient who is to begin taking imipramine [Tofranil] asks the nurse when the drug should be taken. The nurse will instruct the patient to:
a. divide the daily dose into two equal doses 12 hours apart.
b. take the entire dose at bedtime to minim-ize sedative effects.
c. take the medication once daily in the late afternoon.
d. take the medication once daily in the morning.
A
For many patients, taking the entire dose of a TCA at bedtime is advantageous for facilitating adherence, minimizing daytime sedation, and promoting sleep. However, older adult patients are at greater risk for cardiotoxicity and may experience intolerable effects on the heart if the entire dose is taken at once; therefore, twice-daily dosing is recommended in the elderly.
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Which of the following is a true statement about gerontological nursing for patients of different races and ethnic backgrounds?
a. The fact that a nurse is white has no bear-ing on the nurse's ability to care for mi-nority patients or patients of color. b. An encyclopedic accumulation of details of a particular culture is the best prepara-tion for caring for persons from that cul-ture. c. A nurse who works in Illinois does not need to be as concerned about sensitivity to multiple cultures as the nurse who works in California. d. Facial expressions, body language, post-ure, and touch are important elements of communication between a nurse and a pa-tient from a different ethnicity.
A 73-year-old patient with hypertension is awaiting a triple cardiac bypass surgery. The patient is hard of hearing and did not understand what the surgeon said regarding the surgery
The daughter is concerned that the patient does not understand the risks of the surgery. If not clarified, this would be a violation of what principle? a. Autonomy b. Justice c. Fidelity d. Nonmaleficence
A patient comes into the emergency department with a fever, stiff neck, and change in mental status. On assessment it is learned that this patient also has a positive Kernig's sign. These findings suggest the patient:
1. Needs surgery to reduce intracranial pressure 2. Needs to be intubated 3. Should receive 100% oxygen via face mask 4. Has meningeal irritation
What other medications might be prescribed for M.E. and why?
What will be an ideal response?