A nurse is reinforcing teaching with a newly licensed nurse about age-related changes that affect medication administration for older adult clients. Which of the following information should the nurse include?

Choice A rationale Hepatic enzymes typically process medications less rapidly in older adults, not more rapidly. With aging, liver size and hepatic blood flow decrease, along with reduced activity of cytochrome P450 enzymes. This impaired hepatic metabolism prolongs the half-life of many drugs, increasing the risk of accumulation and toxicity. Choice B rationale Organs typically become more sensitive to medications in older adults, not less. This increased sensitivity, particularly in the central nervous system and cardiovascular system, is due to altered receptor affinity, reduced compensatory mechanisms, and decreased organ reserve, which can lead to heightened pharmacological effects and adverse reactions. Choice C rationale Gastric emptying rate generally decreases in older adults, not increases. Age-related physiological changes, such as reduced gastrointestinal motility and diminished splanchnic blood flow, contribute to a slower gastric emptying time. This can delay the absorption of orally administered medications, impacting their onset of action and peak concentrations. Choice D rationale Renal excretion of medications is significantly decreased in older adults due to age-related physiological changes. There is a reduction in glomerular filtration rate (normal range is approximately 90-120 mL/min/1.73m²), decreased renal blood flow, and fewer functional nephrons. This impaired renal clearance leads to drug accumulation and an increased risk of toxicity for renally eliminated medications.