Progressive Care Nursing Certification (PCCN) Practice Exam

In a frail, elderly patient recovering from surgery who displays confusion and lethargy, what should the nurse recognize?

1. Mobilization should be limited to prevent injury

2. The RASS scale should guide medication administration

3. The use of haloperidol is associated with lethal dysrhythmias

4. Moving the patient to a room with a window is a useful distraction technique

The correct answer is: The use of haloperidol is associated with lethal dysrhythmias

In the scenario involving a frail, elderly patient recovering from surgery and exhibiting confusion and lethargy, recognizing the risks associated with medication, particularly haloperidol, is crucial. This antipsychotic, while it can be effective for managing severe agitation or psychosis, is known to pose significant risks in older adults, particularly the potential for lethal dysrhythmias, including Torsades de Pointes. Older patients often have more complex medication profiles and are frequently at increased risk for adverse drug reactions due to factors such as polypharmacy, organ function decline, and changes in pharmacodynamics and pharmacokinetics. Knowing this risk is essential for nursing practice, as it informs the decision-making process regarding the appropriateness of haloperidol usage, especially in a population that may already be vulnerable due to age and postoperative complications. In nursing care, it is vital to take into account not just the immediate needs of the patient but also the broader implications of medication administration on their overall health and safety. Therefore, understanding the connections between certain medications, patient age, and potential cardiovascular effects is key in effective patient-centered care.