The practical nurse (PN) reviews the history of an older adult who is newly admitted to a long-term care facility. Which factor in the resident’s history should the PN consider the most likely to increase the client’s risk for falls?
A.
Ankle ulcer that is healing slowly.
B.
History of alcohol abuse and cigarete smoking.
C.
Recent weight gain of twenty pounds.
D.
Newly prescribed antihypertensive medication.
The correct answer and Explanation is :
The correct answer is D. Newly prescribed antihypertensive medication.
Falls are a major concern for older adults, especially in long-term care settings, where factors such as medications, mobility issues, and chronic illnesses can significantly increase fall risk. Among the options provided, the most concerning factor for fall risk is the newly prescribed antihypertensive medication. Here’s why:
- Antihypertensive Medications and Orthostatic Hypotension:
Antihypertensive medications, which are used to lower blood pressure, can cause a condition known as orthostatic hypotension. This occurs when blood pressure drops suddenly when a person stands up from a sitting or lying position, leading to dizziness, lightheadedness, or fainting. For older adults, who may already have reduced physiological reserves, this increase in dizziness or fainting episodes can significantly heighten the risk of falls. - Age-Related Physiological Changes:
In older adults, the body’s ability to regulate blood pressure diminishes. When combined with antihypertensive medications, this can exacerbate the risk of sudden blood pressure drops, further increasing the likelihood of a fall. Additionally, older adults may have slower reflexes and balance issues, which can make it harder to recover from dizziness or imbalance, leading to falls. - Multiple Medications:
Older adults often take multiple medications (polypharmacy), which can increase the risk of drug interactions and side effects, such as dizziness or confusion. Antihypertensives, in particular, when added to other medications, may cause a compounded risk for falls.
In contrast, the other factors, while significant health concerns, are less immediately linked to fall risks. A slowly healing ankle ulcer (A), history of smoking and alcohol use (B), and recent weight gain (C) are factors that might affect health, but they are not as directly related to the sudden onset of dizziness or balance issues that antihypertensive medications can cause.