A nurse is caring for a client who has a prescription for vancomycin 1 g IV intermittent infusion over 30 min every 12 hr. Which of the following actions should the nurse take?

Request a serum trough level blood draw for 60 min after completion of infusion.

Change the infusion site after each dose administration.

Contact the provider for prescription clarification.

Request a serum peak level to be drawn 30 min prior to infusion.

Answer and Explanation

The Correct Answer is C

A. Requesting a serum trough level blood draw for 60 min after completion of infusion is incorrect. Trough levels should be drawn just before the next dose (not after infusion completion) to ensure therapeutic drug levels and avoid toxicity.
B. Changing the infusion site after each dose administration is incorrect. Vancomycin can cause phlebitis, but routine site changes after every dose are unnecessary unless signs of irritation or infiltration are present.
C. Contacting the provider for prescription clarification is correct. Vancomycin should be infused over at least 60 minutes to reduce the risk of Red Man Syndrome, a histamine reaction that can cause flushing, hypotension, and rash. A 30-minute infusion is too rapid and should be adjusted.
D. Requesting a serum peak level to be drawn 30 min prior to infusion is incorrect. Peak levels are drawn 30–60 minutes after infusion completion, not before infusion. Trough levels, not peak levels, are used to monitor vancomycin dosing.

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Correct Answer is A

Explanation

A. Increase calcium intake: Leuprolide can cause a decrease in bone density, increasing the risk of osteoporosis. Therefore, the nurse should advise the client to increase calcium and vitamin D intake to help maintain bone health.

B. Keep the solution cold for administration: Leuprolide should be stored at room temperature, not refrigerated, for subcutaneous administration.

C. This medication can cause low blood glucose levels: Leuprolide does not typically affect blood glucose levels. However, it can cause other endocrine-related side effects, such as hot flashes and reduced libido.

D. This medication can cause constipation: Constipation is not a common side effect of leuprolide. Instead, leuprolide is more likely to cause side effects such as hot flashes and loss of bone density.

A. Albuterol B. Furosemide C. Digoxin D. Atenolol

Correct Answer is A

Explanation

A. Albuterol: This is a bronchodilator that can cause side effects such as increased heart rate and chest pain due to its stimulant effect on the cardiovascular system.

B. Furosemide: This diuretic is unlikely to cause chest pain directly; however, it may lead to electrolyte imbalances that can indirectly affect cardiac function.

C. Digoxin: While digoxin has several potential side effects, chest pain is not commonly recognized as a direct adverse effect of this medication.

D. Atenolol: This medication is a beta-blocker used to manage hypertension and is unlikely to cause chest pain; rather, it may help alleviate angina symptoms.

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A nurse is caring for a client who has a prescription for vancomycin 1 g IV intermittent infusion over 30 min every 12 hr. Which of the following actions should the nurse take?

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