Question

Which of the following client statements regarding self-medication administration by an older-adult client requires follow-up teaching by the nurse?

1. I take all the pills ordered once a day at bedtime, so I'm less likely to forget them.
2. I have one pill that needs cut in half. I am going to ask the pharmacist to do that for me.
3. The pharmacist said to keep my pills away from the sunlight, so I put them inside the kitchen cabinet.
4. My daughter comes over each morning and puts my pills into a container that sorts them by the time they are due.

Answer 1

The statement about taking all prescribed pills once a day at bedtime requires follow-up teaching because medications often have specific dosing schedules based on their half-life and potential interactions, which must be adhered to for safety and efficacy.

Step-by-step explanation:

In reviewing the client statements regarding self-medication administration by an older-adult client, the statement that requires follow-up teaching by the nurse is: “I take all the pills ordered once a day at bedtime, so I’m less likely to forget them.” This statement needs further teaching because medications have specific dosing times and intervals that are important for their efficacy and to avoid potential toxicity. Taking all medications at once may not be appropriate, as some may require to be taken multiple times a day due to factors such as half-life, or be taken with food, or spaced out from other medications to avoid interactions.

It is essential for the client to understand these aspects of medication administration. The other statements indicate that the client is taking appropriate steps in managing their medication regimen, by asking the pharmacist for assistance in cutting pills (#2), keeping medications away from sunlight as instructed (#3), and having help from a family member to sort the pills (#4).

Answer 2

The client's statement about taking all pills at bedtime requires follow-up teaching due to the complexities of medication timing and dosing (option 1).

Step-by-step explanation:

The statement by the older-adult client that appears to need follow-up teaching by the nurse is: "I take all the pills ordered once a day at bedtime, so I'm less likely to forget them." This statement is concerning because different medications have specific dosing intervals and prerequisites for administration which must be adhered to for them to be effective and safe.

The half-life of a drug, whether it is dose dependent or time dependent, the drug's potential for serious side effects, as well as individual patient factors such as liver or kidney function, can all influence the appropriate timing and dosing of medication. Taking all medications at once could lead to decreased efficacy of some drugs and increased risk of toxic side effects for others.

Hence, the answer is option 1.