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

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

Two hours after completion of the IV dose and two hours before the next administration of the medication.

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

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

Explanation:

Peak levels measure the highest concentration of the drug in the bloodstream and should be drawn immediately after the IV infusion is completed.
Trough levels measure the lowest concentration of the drug and should be drawn 30 minutes before the next scheduled dose. This helps ensure the drug remains within therapeutic levels and prevents toxicity.

Why the other options are incorrect:

A. One hour after completion of the IV dose and one hour before the next administration – Waiting one hour for the peak level is too long and may lead to an inaccurate measurement.
B. Two hours after completion of the IV dose and two hours before the next administration – Waiting two hours for both peak and trough levels is too late for effective monitoring.
C. Thirty minutes into the administration of the IV dose and 30 minutes before the next administration – The sample drawn mid-infusion does not represent peak levels, making this method ineffective.

Key takeaway:

Proper timing of vancomycin peak and trough monitoring ensures therapeutic drug levels while minimizing nephrotoxicity and ototoxicity.

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Correct Answer is C

Explanation

Choice A rationale

While a family history of mental illness is important information to obtain when planning care for a client with major depression, it is not the most important information when the client is receiving a new prescription for duloxetine. Family history can provide insight into the client’s risk factors for depression, but it does not directly impact the safety or efficacy of duloxetine.

Choice B rationale

Weight change in the last month is not the most important information to obtain when planning care for a client with major depression who is receiving a new prescription for duloxetine. While significant weight changes can be a symptom of depression and should be monitored, they do not directly impact the safety or efficacy of duloxetine.

Choice C rationale

Liver function laboratory results are the most important information to obtain when planning care for a client with major depression who is receiving a new prescription for duloxetine.

Duloxetine is metabolized in the liver, and abnormal liver function can affect the metabolism and elimination of the drug, potentially leading to increased side effects or decreased effectiveness. Therefore, it is crucial to assess liver function before and during treatment with duloxetine.

Choice D rationale

While recent use of other antidepressants is important information to obtain when planning care for a client with major depression who is receiving a new prescription for duloxetine, it is not the most important information. This information can help prevent drug interactions and serotonin syndrome, a potentially life-threatening condition. However, liver function has a more direct impact on the safety and efficacy of duloxetine.

A. Monitor the client’s blood pressure. B. Assess the client’s urine output. C. Perform a bladder scan. D. Obtain the client’s daily weights.

Correct Answer is A

Explanation

Choice A rationale

Tamsulosin is an alpha-blocker that relaxes the smooth muscles of the prostate and bladder neck, improving urine flow. However, it can also cause hypotension, dizziness, and fainting as adverse effects. Therefore, monitoring blood pressure is essential for clients taking tamsulosin.

Choice B rationale

While assessing the client’s urine output is an important part of monitoring a client with benign prostatic hyperplasia, it is not specifically related to monitoring for adverse reactions to tamsulosin.

Choice C rationale

Performing a bladder scan can be useful in assessing the client’s urinary retention, a common symptom of benign prostatic hyperplasia. However, it is not specifically related to monitoring for adverse reactions to tamsulosin.

Choice D rationale

Obtaining the client’s daily weights can be useful in monitoring fluid balance, but it is not specifically related to monitoring for adverse reactions to tamsulosin.

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

Explanation:

Why the other options are incorrect:

Key takeaway:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. What information is most important for the nurse to obtain?

Correct Answer is C

Explanation

A client with benign prostatic hyperplasia has been prescribed tamsulosin. What should the nurse do to monitor for an adverse reaction?

Correct Answer is A

Explanation

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