A client with an infection is being treated with vancomycin. The nurse providing care reviews the client's laboratory reports and notes that the client's blood urea nitrogen (BUN) and serum creatinine levels are newly elevated. What would be the appropriate nursing intervention?
Instruct the client to notify the nurse if they have any tingling in their toes.
Interpret the peak and trough levels.
Assess the client's urine output.
Consult the provider about the need for a less nephrotoxic medication.
The Correct Answer is B
a) Tingling in the toes may be indicative of peripheral neuropathy but is not specifically related to elevated BUN and serum creatinine levels.
b) Elevated BUN and serum creatinine levels suggest potential renal impairment, and interpreting peak and trough levels of vancomycin is essential to assess the drug's impact on renal function.
c) Assessing urine output is important in evaluating renal function, but the specific action related to the elevated BUN and creatinine levels is to interpret vancomycin levels.
d) Consulting the provider about the need for a less nephrotoxic medication may be a consideration, but understanding the impact of vancomycin on renal function through peak and trough levels is a crucial initial step.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
a) Spironolactone is a potassium-sparing diuretic, and the use of salt substitutes, which often contain potassium chloride, can lead to increased potassium levels, posing a risk of hyperkalemia.
b) Continuing medication even when feeling well is generally advised, especially for chronic conditions. Discontinuing medication without medical guidance is not recommended. c) While a healthy diet is important, this option does not specifically address the unique considerations related to spironolactone use.
d) Checking the pulse is not directly related to self-care in terms of the medication's side effects or interactions.
Correct Answer is B
Explanation
a) Vitamin D levels may be affected by long-term glucocorticoid use, but the described symptoms are more indicative of potential glucocorticoid-related side effects, such as Cushingoid features, which warrant liver function tests.
b) Liver function tests are appropriate to assess the impact of long-term glucocorticoid use on the liver, as these medications can affect liver function.
c) Serum electrolytes are important to monitor, but the specific symptoms mentioned (full cheeks, hump of fat) are not typically associated with electrolyte imbalances.
d) A tuberculin skin test is unrelated to the observed symptoms and is not typically ordered based on the physical features described.
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