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. Breastfeeding is not recommended while taking this medication:

While it's important to avoid breastfeeding while taking isotretinoin due to potential risks to the infant, the priority in this scenario is preventing exposure to the medication during pregnancy.

The most important information for the nurse to provide to a young adult female client planning to become pregnant while taking isotretinoin for cystic acne is:

B. Discontinue this medication one month before attempting to conceive.

Explanation: Isotretinoin (commonly known as Accutane) is a teratogenic medication, which means it can cause severe birth defects if taken during pregnancy. Therefore, it is crucial for the client to discontinue this medication well before attempting to conceive. The recommended time frame to wait after stopping isotretinoin before attempting conception varies but is generally at least one month. The specific duration should be discussed with the healthcare provider.

C. Do not take multiple vitamins that contain vitamin A while taking this drug:

Avoiding excessive vitamin A intake is important to prevent vitamin A toxicity, but it is not the most critical piece of information for a client planning to become pregnant while on isotretinoin.

D. Baseline liver function results must be obtained during therapy:

Monitoring liver function is important during isotretinoin therapy, but the priority in this scenario is preventing fetal exposure to the medication by discontinuing it before attempting pregnancy.

A. Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication. B. Two hours after completion of the IV dose 2nd 00 0000 before the next administration of the medication. C. One how after completion of the IV dose and one hour before the next administration oldie medication. D. Immediately after completion of the IV dose and 30 minutes before the next administration of the medication.

Correct Answer is D