A 74-year-old man who has just returned to the medical-surgical floor following surgery for a total knee replacement says he has "been confused in the past" when he takes pain medications. The nurse realizes that the elderly may:
A) Require lower doses of medication and are easily confused with new medications
B) Have altered absorption and metabolism, which prohibits the use of opiates
C) Be confused following surgery and that is related to normal aging and unrelated to the medication
D) Require a higher initial dose of pain medication followed by a tapered dose
Ans: A
Feedback: The elderly often require lower doses of medication and are easily confused with new medications. They 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.
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