Nurses have the authority to compound, dispense and administer medications according to the regulation under the Nurses (registered) and Nurse Practitioners Regulation. Nurses are required to put some factors into consideration to safely administer medications. The nurses are required to utilize the Dispensing Medications practice standard which contains various principles guide medication administration. Employers and organizations in the healthcare systems are responsible for providing support and methods which are necessary for safe medication administration.
Young age patients also referred to as pediatric patients are not considered as adults during medication administration. There are some physiologic differences between pediatric and adult patients which may result in age-related changes in pharmacokinetics and pharmacodynamics (Chen et al, 2017). Pharmacokinetics refers to the study of the time of absorption, metabolism, distribution, and excretion of a drug. The rate of absorption between the pediatric patient and the adult patients is different (Alsulami et al, 2014). Absorption rate with the pediatric patients is based on factors such as health, age, weight and the route of administration. The absorption rate of an infant becomes more efficient as the child grows. On the other hand, hydration also affects the GI tract which in turn affects the absorption rate; The GI disorder is likely to change the absorption rate of medications if the medication is being administered orally (Alsulami et al, 2014). Nurses, therefore, need to consider this factor where choosing the correct medication administration. Modification in the medication administration may be required if need be.
Also, nurses need to be aware that the peak serum concentrations are likely to be reduced by delayed emptying. For example, absorption time decreases in a pediatric who has delayed peristalsis or diarrhea. Pediatrics have a more top GI surface in the intestines and the stomach compared to adults. Additionally, distribution of medication in the body of infants is affected by some factors. These include; effectiveness of barriers to the transport of drugs, infants body tissue composition, fluid composition and protein binding capabilities. Infants below two years have a higher percentage of water compared to children who have about two years and over. This excellent water concentration allows for a medication with a lower dose concentration of the drug to be administered. Children above two years require higher doses of water-soluble medication to attain the necessary effect.
Older adults, on the other hand, require medication administration tailored to their particular need just like the case in pediatrics. The older patients have a decreased gastric acidity which affects the absorption of the administered medication (Forlenza et al, 2017). Additionally, these patients have a decrease in cardiac output which is caused by the reduced blood flow in the GI tract. This slows down the absorption rate of the drug into the body. Old patients as it is in the case of infants have decreased water content in the body. Therefore, soluble drugs become more concentrated. The chances for adverse drug interaction are increased in old patients by the low protein binding capabilities. Elderly adult patients have a low metabolism rate. This is caused by the decrease in the liver size of the older adults. This reduces the absorption rate in the older adult because drug clearance by hepatic metabolism is reduced (Forlenza et al, 2017).
In conclusion, it is critical to ensure that all medications are administered as per the guidelines and principles for both the two age groups, i.e., young children and older adult patients. Drug toxicity should be prevented with the help of family members as well as the patients. Nurses should stress on monitoring signs and symptoms which occur when various medications have been administered. It is crucial for nurses to consider all factors that play a role in absorption and distribution of drugs administered in the two ages.
Alsulami, Z., Choonara, I., & Conroy, S. (2014). Paediatric nurses adherence to the doublechecking process during medication administration in a children's hospital: an observational study. Journal of advanced Nursing, 70(6), 1404-1413.
Chen, N., Zhou, S., & Palmisano, M. (2017). Clinical pharmacokinetics and pharmacodynamics of lenalidomide. Clinical pharmacokinetics, 56(2), 139-152.
Forlenza, G. P., Argento, N. B., & Laffel, L. M. (2017). Practical considerations on the use of continuous glucose monitoring in pediatrics and older adults and nonadjunctive use. Diabetes Technology & Therapeutics, 19(S3), S-13.
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