An elderly patient is admitted to the hospital with cardiac complications associated with diabetes. What should be of concern to the nurse regarding this patient's medications?
1. The type and amount of medications in relation to the patient's renal function
2. Whether the patient is taking the prescribed dosages
3. Which vitamins and supplements the patient is taking
4. The cost of the patient's medications
1
Rationale 1: A decreased glomerular filtration rate (GFR) in the older adult reduces the clearance of drugs excreted through the kidneys, prolonging the half-life of drugs and possibly requiring lower drug doses and longer dosing intervals. Common medications affected by decreased GFR include cardiac medications and antidiabetic agents.
Rationale 2: Assessing the patient's compliance with prescribed doses is important in any circumstance but is not specific to this scenario.
Rationale 3: Use of vitamin supplements should be assessed, but it is not specific to the situation described.
Rationale 4: The nurse might suspect noncompliance if the cost of medications is an issue. This concern would not be specific to this scenario, however.
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