A nurse is caring for a client who has an infection and a prescription for gentamicin Intermittent IV bolus every 8 hr. A peak and trough are required with the next dose. Which of the following actions should the nurse take to obtain an accurate gentamicin serum level?
Draw a peak level 90 min prior to administering the medication and a trough level 90 min after the dose.
Draw a trough level immediately prior to administering the medication and a peak level 30 min after the
dose.
Draw a trough level at 0900 and a peak level at 2100.
The Correct Answer is B
To obtain an accurate gentamicin serum level, the nurse should draw a trough level immediately before administering the next dose of medication and a peak level 30 minutes after the dose has been administered. The trough level measures the lowest concentration of the medication in the blood, while the peak level measures the highest concentration.

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Related Questions
Correct Answer is C
Explanation
Sublingual and buccal medications are rapidly absorbed because they are placed under the tongue or between the cheek and gum, where they dissolve and are absorbed directly into the bloodstream through the mucous membranes in the mouth. This allows for rapid absorption and bypasses the liver’s first-pass metabolism.

Correct Answer is A
Explanation
Prophylactic antibiotics are antibiotics given to prevent an infection from occurring. They are often used in situations where there is a high risk of infection, such as during surgery or dental procedures. However, prophylactic antibiotics are not recommended for all clients.
Option b is a situation where prophylactic antibiotics are recommended. Clients with prosthetic heart valves are at an increased risk of developing infective endocarditis (infection of the heart lining) during dental procedures due to the risk of bacteria entering the bloodstream.
Option c is another situation where prophylactic antibiotics may be used. Clients who have had an emergency cesarean section are at an increased risk of developing post-operative infections, and prophylactic antibiotics may be given to prevent this.
Option d is also a situation where prophylactic antibiotics may be used. Total hip arthroplasty is a surgical procedure that involves replacing the hip joint with a prosthesis. Clients who undergo this procedure are at an increased risk of developing a surgical site infection, and prophylactic antibiotics may be given to prevent this.
Option a, on the other hand, does not warrant prophylactic antibiotics. A fever of unknown origin does not necessarily indicate an infection, and antibiotics should only be given when there is a confirmed bacterial infection. Inappropriate use of antibiotics can lead to antibiotic resistance and other adverse effects.
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