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 C

Explanation

A. Furosemide is a diuretic that promotes urine production but is not indicated for treating bladder distention or urinary retention post-surgery.

B. Lorazepam is an anxiolytic medication and does not address urinary retention or bladder distention.

C. Bethanechol is a cholinergic agent that stimulates bladder contraction and is used to treat urinary retention. It helps to facilitate voiding in clients who have difficulty.

D. Atropine is an anticholinergic medication that can actually inhibit bladder contraction, making it inappropriate for this situation.

A. Increased heart rate B. Increased blood pressure C. Decreased pulmonary congestion D. Decreased anginal pain

Correct Answer is D

Explanation

A. Verapamil is a calcium channel blocker that typically decreases heart rate rather than increases it. Therefore, an increased heart rate would not be a therapeutic response to this medication.

B. Verapamil works to lower blood pressure by inhibiting calcium influx into the vascular smooth muscle. An increase in blood pressure would not be an expected therapeutic outcome.

C. While verapamil may help with heart function, the primary therapeutic response is not specifically measured by decreased pulmonary congestion. This outcome may not be directly observable in the early treatment phases post-myocardial infarction.

D. Verapamil is effective in reducing anginal pain by decreasing myocardial oxygen demand through lowering heart rate and contractility. Thus, a decrease in anginal pain would be a direct therapeutic response to the medication.

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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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Naxlex Comprehensive Predictor Exams

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Explanation

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