A nurse is administering drugs to a 70-year-old patient who has a reduced plasma albumin level. When assessing the patient for therapeutic outcomes of drug therapy, the nurse will also be careful to observe for
possible drug toxicity.
decreased therapeutic effects.
altered drug absorption.
increased drug metabolism.
The Correct Answer is A
A. A reduced plasma albumin level can lead to increased free drug levels in the bloodstream, raising the risk of drug toxicity, particularly for highly protein-bound medications.
B. Decreased therapeutic effects are less likely because the decrease in albumin can lead to higher free drug concentrations, which may actually increase effects rather than decrease them.
C. Altered drug absorption is generally not directly influenced by plasma albumin levels; it relates more to gastrointestinal factors.
D. Increased drug metabolism is not a direct consequence of lower albumin levels; instead, the concern is primarily about increased free drug concentrations and potential toxicity.
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Correct Answer is D
Explanation
A. Giving the drug with food may delay absorption but does not affect the extent of the first-pass effect.
B. Administering the drug in small, frequent doses may help maintain therapeutic levels but will not significantly alter the first-pass effect.
C. Limiting protein intake could reduce drug binding to proteins, but this is not a standard approach for managing first-pass metabolism.
D. Administering the drug intravenously bypasses the gastrointestinal tract and liver, avoiding the first-pass effect, thereby increasing the amount of free drug available to body cells.
Correct Answer is B
Explanation
A. Using combination therapy may be beneficial in some cases but is not the first step in ensuring the most appropriate drug is chosen for a specific pathogen.
B. Obtaining sensitivity testing is essential to determine the specific antibiotic to which the pathogen is susceptible, ensuring effective treatment.
C. Checking client allergies is important to prevent adverse reactions but does not directly address whether the chosen drug is appropriate for the pathogen.
D. Evaluating the bactericidal effects is part of assessing the treatment's effectiveness, but it should follow sensitivity testing to determine the correct medication.