NU 629 Week 10 Discussion Elder Specific Discussion Topics

NU 629 Week 10 Discussion Elder Specific Discussion Topics

Polypharmacy is common among the older adult population. “Polypharmacy is defined as the prescription of multiple drugs to an individual” (Soler & Barreto, 2019). It is associated with higher risk for falls, adverse drug reactions, increased hospital stay, and increased likelihood of readmission shortly after discharge (Masnoon et al., 2017). Older adults are more at risk for adverse drug reactions from polypharmacy due to decreased renal and hepatic function, decreased lean body mass, and decreased mobility (Masnoon et al., 2017). Polypharmacy can also cause vision and cognition impairment which can affect compliance and reduce older adults’ quality of life (Dahal, 2021). Other complications include frailty, disability, and delirium (Dahal, 2021).

There are many ways in which polypharmacy can be avoided. It is important that before prescribing any new medication that the benefits and risks of the medication are evaluated along with the patient’s other prescribed medications and over the counter medications (Dahal, 2021). At every doctor visit, the patient’s medications should be reviewed to determine their safety and effectiveness (Dahal, 2021). The Beers criteria is a common approach used to help improve the selection of prescription drugs (Dahal, 2021). The Beer’s criteria provides a list of high risk medications that “should be avoided or used with caution, used in reduced dosage, and list the possible alternatives” (Dahal, 2021). By paying close attention to what medications older adult patients are prescribed, we can help decrease polypharmacy. As a future APRN, I will be sure to reevaluate my patients medication list at every visit to determine long term effects of each medication and to determine if any medications have similar mechanisms of action.

References
Dahal, R. (2021, November 2). Strategies to reduce polypharmacy in the elderly. Statpearls. Retrieved November 3, 2021, from https://www.statpearls.com/ArticleLibrary/viewarticle/131249.

Masnoon, N., Shakib, S., Kalisch-Ellett, L., & Caughey, G. E. (2017, October 10). What is polypharmacy? A systematic review of definitions. NCBI. Retrieved November 3, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5635569/.

Soler, O., & Barreto, J. O. M. (2019, April 2). Community-level pharmaceutical interventions to reduce the risks of polypharmacy in the elderly: Overview of systematic reviews and economic evaluations. NCBI. Retrieved November 3, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454558/.

Initial Post

Please choose one of the following topics and respond to the thread corresponding to the question you select. Please include at least three scholarly sources within your initial post.

Note: As you are choosing a topic, please try to make sure that all topics are chosen at least by one person. You can see this by noting if anyone has posted to the topic within the corresponding threads.

Dementia in the elderly. Discuss ways in which the cost associated with dementia can be curtailed along with maintaining the individual’s quality of life. Dementia is not only Alzheimer’s disease, so please consider multiple types of dementia within your answers (types of dementia include: Alzheimer’s disease, vascular dementia, dementia with Lewy bodies [DLB], mixed dementia, Parkinson’s disease, frontotemporal dementia, Creutzfeldt-Jakob disease, and normal pressure hydrocephalus).

Elder abuse. Include physical, emotional, sexual, etc. How, as an APRN, can you screen for and address elder abuse? What types of health promotion concepts can be used to help advocate for the personal safety of our elders? Are there screening tools available? In what unconventional locations within your community might an elder screening be performed?

Fall prevention. What are specific geriatric risk factors that create an increase in fall risks? What can be done from a health promotion standpoint to decrease falls in the elderly? Define fall risk and what types of assessments are available in the outpatient and inpatient settings.

Financials, levels of neglect in the elders. Consider financial risk, scams, family, and other pitfalls the elderly may find themselves in relating to their finances. Provide examples and ways to advocate for our patients and our communities as an advanced practice nurse.

Components of a well elder evaluation. Define a well elder evaluation. Make sure you address components that pertain to the home environment and the communities in which they live. How can an APRN assist in these evaluations and promote different aspects within your community.

Functional status. Consider ADLs and IADLs. What is the difference? What types of assessment can be done and by whom to determine if an elder is capable of caring for themself at home. In addition, what types of services are available to help promote overall elder health not only in their homes but when living with family or in assisted living and nursing homes? What types of supportive services are available to assist the elderly in staying in their own homes?

Cognition. Describe how cognitive functioning may change as we age. What are neuropsychological examinations, and when should these be requested? Describe what this type of testing can accomplish and how, as a provider, you would use these results. Discuss ways in which we can improve and maintain our cognitive health (for example, diet, exercise). Provide specifics.

Polypharmacy. Consider medication compliance, risk of adverse effects, creatinine clearance <50ml/min. As an Advanced Practice Nurse, how can you address this growing problem? What type of surveillance will you put into place within your own practice, and how can you advocate to help address this concern within your own community?

Pain assessment and treatment. Discuss specifics regarding pain within the elder population: perception of pain, pain assessment scales, etc. In addition, provide evidence-based cited information relating to the opioid epidemic within your state and what percentage of addicted individuals are elderly. What type of resources are available in your community to help those with substance abuse problems? Are there any services specific to the elderly?

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ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.

Also Read: NU 629 Week 9 Discussion Helping Adults Stay Healthy

Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.

One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.

I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.

In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.

Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).

Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).

Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.

I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.

As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.

It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.