An older client takes meperidine daily for arthritic pain. Which finding is most concerning?

Question

1. The client has a low glomerular filtration rate.
2. The client is arousable only to touch and voice.
3. The client has a history of a seizure disorder.
4. The client reports headaches, dizziness, and ataxia.

Answer 1

4. The client reports headaches, dizziness, and ataxia.

Explanation: 1. The client with decreased kidney function is at risk for accumulating toxic metabolites more easily, leading to complications. This potential risk is less concerning than current assessment findings.
2. Good pain management can sometimes result in a client who is sleepy. As long as the respiratory rate and depth is adequate and the client is arousable, there is no serious concern.
3. The metabolite buildup from meperidine can result in seizures, but the client's history of seizures represents a potential increased seizure risk rather than a current concerning finding.
4. Meperidine is not recommended for treatment of persistent pain in older persons because it tends to cause accumulations of toxic metabolites that can cause delirium, ataxia, and dizziness.