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

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

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.

Answer and Explanation

The Correct Answer is A

A. Immediately after completion of the IV dose and 30 minutes before the next administration of the medication: This timing is correct for monitoring vancomycin levels. The peak level is typically measured immediately after the completion of the infusion (though peak levels are less commonly required for vancomycin), and the trough level is measured just before the next dose is due, 30 minutes before administration. This approach helps in evaluating the medication's efficacy and safety.
B. One hour after completion of the IV dose and one hour before the next administration of the medication: This timing is not ideal. The peak level for vancomycin is usually measured immediately after the dose rather than one hour later. Trough levels are measured closer to the next dose, typically 30 minutes before the next dose.
C. Two hours after completion of the IV dose and two hours before the next administration of the medication: Measuring levels two hours after the dose completion is too late for a peak level. The trough level should be measured closer to the next dose, generally 30 minutes before the next administration.
D. Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication: Measuring the level 30 minutes into the infusion is not appropriate for peak levels, which are typically measured.

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Free Nursing Study Resources

Correct Answer is D

Explanation

A. Administer sucralfate once a day, preferably at bedtime: Sucralfate is typically administered multiple times a day, not just once. It is commonly given in divided doses, often four times a day, to ensure adequate coverage and effectiveness. Administering it at bedtime alone would not provide consistent therapeutic effects.
B. Monitor for electrolyte imbalance: Sucralfate is not known to cause significant electrolyte imbalances. It works locally in the gastrointestinal tract and does not usually affect electrolyte levels, so monitoring for electrolyte imbalances is not a primary concern with this medication.
C. Assess for secondary Candida infection: While sucralfate may affect the gastrointestinal flora, secondary Candida infections are not a common side effect. Sucralfate is not an antibiotic and does not typically lead to fungal infections.
D. Give sucralfate on an empty stomach: Sucralfate should be administered on an empty stomach, ideally 1 hour before meals or 2 hours after meals. This allows the medication to properly adhere to the ulcer site and form a protective barrier, enhancing its effectiveness in treating peptic ulcers.

A. Withhold the medication until the client's breakfast tray is available on the unit. B. Consult with a pharmacist about scheduling the dose one hour after the client eats. C. Instruct the client that it is necessary to take nothing but water with the medication. D. Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low fat milk.

Correct Answer is C

Explanation

A. Withhold the medication until the client’s breakfast tray is available on the unit: Withholding the medication until food is available is not necessary, as risedronate should be taken on an empty stomach to ensure proper absorption. Food can interfere with the medication's effectiveness.
B. Consult with a pharmacist about scheduling the dose one hour after the client eats: This option is not suitable as risedronate should be taken on an empty stomach, and delaying the dose until after eating would compromise the medication's effectiveness.
C. Instruct the client that it is necessary to take nothing but water with the medication: Risedronate must be taken on an empty stomach with a full glass of water and the client should remain upright for at least 30 minutes afterward. Milk or other beverages can interfere with the absorption of risedronate.
D. Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low-fat milk: This is not appropriate, as risedronate should be taken with water only to ensure proper absorption. Milk can reduce the effectiveness of the medication.

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

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