A client is receiving intravenous (1V) vancomycin and the nurse plans to draw blood for a peak a. trough to determine the serum level of the drug. Which collection times provide the best determination of these levels?

Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication.

Two hours after completion of the IV dose 2nd 00 0000 before the next administration of the medication.

One how after completion of the IV dose and one hour before the next administration oldie medication.

Immediately after completion of the IV dose and 30 minutes before the next administration of the medication.

Answer and Explanation

The Correct Answer is D

A. Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication:

This timing doesn't align with the standard practice of drawing peak levels immediately after the IV dose is completed.

The trough level should be taken just before the next dose, not 30 minutes before.

B. Two hours after completion of the IV dose and 1 hour before the next administration of the medication:

Waiting for two hours after the dose to draw the peak level is too long. Peak levels are typically drawn immediately after completion.

Drawing the trough level one hour before the next dose doesn't provide an accurate assessment of the lowest drug concentration just before the next administration.

C. One hour after completion of the IV dose and one hour before the next administration of the medication:

Similar to choice B, waiting one hour after the dose to draw the peak level is not in line with standard practice.

Drawing the trough level one hour before the next dose is administered is too early to accurately represent the lowest concentration.

The best collection times for determining the peak and trough levels of intravenous (IV) vancomycin are:

D. Immediately after completion of the IV dose and 30 minutes before the next administration of the medication.

Explanation:

Peak Level: Peak levels of vancomycin are drawn immediately after the completion of the IV dose. This is done to assess the highest concentration of the drug in the bloodstream, which is important for ensuring its therapeutic efficacy and monitoring for potential toxicity.

Trough Level: Trough levels are drawn just before the next dose is administered. A trough level represents the lowest concentration of the drug in the bloodstream, ensuring that the drug is still present at a therapeutic level before the next dose is given. Taking the trough level 30 minutes before the next administration is appropriate, as it allows time for the drug to reach its lowest concentration before receiving the next dose.

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Correct Answer is B

Explanation

A. Lorazepam:

Lorazepam is a benzodiazepine used for its anxiolytic and sedative effects. It is not known to cause AKI. Monitoring for sedation and respiratory depression may be necessary, but this is unrelated to kidney function.

The client the nurse should closely monitor for the development of acute kidney injury (AKI) when administering medications is:

B. Vancomycin.

Explanation: Vancomycin, an antibiotic commonly used to treat bacterial infections, has the potential to cause nephrotoxicity (kidney damage), especially when given in high doses or over a prolonged period. Therefore, clients receiving vancomycin should be closely monitored for signs of AKI, including changes in urine output, serum creatinine levels, and other renal function indicators.

C. Sucralfate:

Sucralfate is a medication used to treat and prevent gastrointestinal ulcers. It is not typically associated with AKI. Monitoring for gastrointestinal side effects is more relevant when administering sucralfate.

D. Digoxin:

Digoxin is a medication used to treat heart conditions. While it can affect renal function, it is not a primary cause of AKI. Monitoring serum digoxin levels and assessing for signs of digoxin toxicity are important when administering digoxin, but it is not the primary concern for AKI.

A. Take milk or antacids to prevent gastrointestinal (GI) irritation. B. Protect the skin from sunlight while taking the drug. C. Return to the clinic weekly to obtain serum drug levels. D. Take with orange juice to enhance GI absorption

Correct Answer is B

Explanation

A. Take with milk or antacids to prevent gastrointestinal (GI) irritation:

Tetracycline should not be taken with milk or antacids because these can bind to the medication and reduce its absorption. It is generally recommended to take tetracycline with a full glass of water on an empty stomach, unless otherwise instructed by the healthcare provider.

When providing instructions to a client prescribed tetracycline HCl, the nurse should include the following instruction:

B. Protect the skin from sunlight while taking the drug.

Explanation: Tetracycline antibiotics can make the skin more sensitive to sunlight (photosensitivity). Exposure to sunlight or ultraviolet (UV) rays can lead to severe sunburn reactions. Therefore, it is important for clients taking tetracycline to avoid prolonged exposure to direct sunlight and to use sunblock, protective clothing, and sunglasses when outdoors. This precaution helps prevent skin irritation and sunburn.

C. Return to the clinic weekly to obtain serum drug levels:

Routine monitoring of serum drug levels is not typically required for clients taking tetracycline. Monitoring may be necessary for other medications, but it is not a standard practice for tetracycline.

D. Take with orange juice to enhance GI absorption:

Like milk and antacids, taking tetracycline with orange juice can interfere with its absorption. It is generally recommended to take tetracycline with a full glass of water on an empty stomach for optimal absorption.

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A client is receiving intravenous (1V) vancomycin and the nurse plans to draw blood for a peak a. trough to determine the serum level of the drug. Which collection times provide the best determination of these levels?

Nursing Test Bank

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