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.

Answer and Explanation

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.

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Correct Answer is D

Explanation

a) The statement about rotating acetaminophen with ibuprofen for pain control demonstrates an understanding of the principles of multimodal pain management and is appropriate.

b) The statement about taking two oxycodone-acetaminophen tablets if pain persists after a certain time frame is appropriate and reflects awareness of appropriate pain management strategies.

c) The statement about the maximum daily dose of acetaminophen and its potential to cause liver problems is accurate and indicates good knowledge.

d) The statement about acetaminophen masking infection-related fevers is incorrect. While acetaminophen can reduce fever, it does not mask the presence of an infection. This statement indicates a need for further teaching.

A. "Take the digoxin at bedtime." B. "Eat a diet high in bran, fiber, and calcium." C. "You must be able to check your pulse." D. "Don't take digoxin if your heart rate exceeds 90 beats per minute."

Correct Answer is C

Explanation

a) Taking digoxin at bedtime is not a critical instruction. The important aspect is to take it consistently at the same time each day.

b) A diet high in bran, fiber, and calcium is not specifically related to digoxin administration. Digoxin has specific dietary considerations related to potassium levels.

c) Checking the pulse is crucial for a client taking digoxin, as it helps monitor for potential toxicity. Digoxin can cause bradycardia, and the pulse rate is an essential parameter to assess before administering each dose.

d) While monitoring the heart rate is important, setting a specific threshold (e.g., not taking digoxin if the heart rate exceeds 90 beats per minute) is not a standard recommendation. It's generally more nuanced and individualized.

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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?

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Naxlex Comprehensive Predictor Exams

A client who is recovering from total knee surgery is preparing for discharge. Which of these statements indicates the client needs further teaching?

Correct Answer is D

Explanation

What should the nurse include in a client's discharge teaching when going home with a prescription for digoxin 0.125 mg by mouth once daily?

Correct Answer is C

Explanation

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