Question

Medication administration is modified to meet the needs of the individual patient.

• Compare and contrast safe medication administration for a very young and very old patient.
• Consider pharmacokinetics, nursing implications and /or health teaching as you create your post.

Answer 1

For very old patients drug testing and establishing of therapeutic dosage does not take into account the unique characteristics of older adults.Older adults normally have some change in the body function and are more likely to suffer from atleast one disease process ;they are not physiologically the same as younger adults.

Nurses must be sure to assess older residents thoroughly before administering any medications.Nurses should monitor older adults continually to determine whether the medication is having the desired effect.Residents should also be observed for any untoward effects or significant changes in medical condition or behaviour.Nurses should be particularly watchful for any signs of overdose or toxicity.Identify information that should be provided to older adults regarding medications.Ageing affects the bodys ability to handle drugs.Increase in body fat and overall decrease in water can increase concentration of water soluble drugs and cause a prolonged effect of fat soluble drugs.Hepatic blood flow can decrease by 50% in those >65 can result in increased toxicity due to 1st pass effect.>1st pass effect drugs are significantly metabolized when they first flow through the liver can increase concentration of drugs.

The ideal situation for dosing of children is looking at the label and following the paediatric dosing guidance.paediatric pharmacokinetics are different from adult because of growth and maturation.Nurses should be aware as not to assume that a child or infant can recieve the adult dose,assume that the child or infant dose is proportional by body weight to the adult dose.Absorption ,distribution,metabolism and elimination factors differ across age within the paediatric age category.Absorption decreases in neonates and in children that are ill.At 1 year of age,pharmacokinetic parameters are similar to those of adults.The main pharmacodynamic differences that medication have on children over adults are behaviour of medication at cellular level,immaturity of many body systems,may enhance or decrease medication effectiveness,and dosage often altered from adult dose to ensure efficacy without toxicity.When dealing with a paediatric child while attempting to give medications explain on their level what the medication is ,why they need it ,what the child will experience,what is the expected of the child and how parents can help.