Pharmacology Pharmacokinetics #1

Question

When the nurse is administering medication, which client would the nurse understand has the greatest predisposition to an adverse reaction?

Answers

  1. A 9-year-old with an ear infection
    • Rationale:

      This is not the correct answer because an acute condition of an ear infection is at a much lower risk for adverse effects compared to the client with kidney disease, due to the high risk of drug accumulation in the body associated with kidney disease. Younger clients, specifically infants, are at greater risk for adverse medication reactions related to their immature kidneys and liver. Nevertheless, in this scenario, the 9 year-old has the lower risk compared to the client with kidney disease.

  2. A 30-year-old man with kidney disease
    • Rationale:

      This is the correct answer because kidney disease greatly affects the pharmacokinetics of drugs, which profoundly predisposes clients to adverse effects. Toxic medication levels can quickly occur in this client, causing life-threatening adverse effects.

  3. A 50-year-old with and upper respiratory infection
    • Rationale:

      This is not the correct answer because an upper respiratory infection is acute and minor compared to kidney disease. The pathology of kidney disease profoundly predisposes any aged client to adverse medication reactions, especially compared to acute respiratory infections.

  4. A 75-year-old woman with cystitis
    • Rationale:

      This is not the correct answer because a 75-year-old woman with cystitis is an acute infection compared to a chronic medical condition of kidney disease. Elderly clients are at high risk for adverse reaction, but in this scenario, the elderly client has an acute condition, cystitis, which is less concerning than a middle aged client with a chronic condition, kidney disease.

Overview

Adverse reactions are not the intended purpose of medication therapy. Kidney and liver disease significantly increase the risk for adverse drug reactions in clients.

Explanation

Learning Outcomes

Kidney disease predisposes clients to severe adverse reactions to medications. This is due to the risk of having the drug accumulate to a toxic level due to potential excretion difficulties. Elderly clients and infants are also at high risk for adverse reaction, but in this scenario, the elderly client has an acute condition, cystitis, which is less concerning than a middle aged client with a chronic condition, kidney disease. Kidney disease greatly affects the pharmacokinetics of drugs, which profoundly predisposes clients to adverse effects.

Test Taking Tip

The extreme ages (very young and very old) are significantly vulnerable to health problems and their medical treatments, especially medications. Other vulnerable populations are those with chronic illness, including liver and kidney dysfunction.

Video Rationale