A nurse is caring for a client who is at risk for alcohol withdrawal delirium.
Which of the following medications should the nurse expect the provider to prescribe?

Choice A rationale

Trough levels should be drawn just before the next dose, not 60 minutes after infusion, to ensure accurate assessment of the lowest concentration of vancomycin in the patient's bloodstream.

Choice B rationale

There is no need to change the infusion site after each dose unless there are signs of phlebitis or infiltration. Consistent monitoring of the site for adverse reactions is sufficient.

Choice C rationale

Contacting the provider for prescription clarification is necessary if the infusion duration seems too rapid. Vancomycin should be infused over at least 60 minutes to reduce the risk of red man syndrome.

Choice D rationale

Peak levels should be drawn 1-2 hours after infusion completion, not before. Monitoring peak levels helps in assessing the maximum concentration of vancomycin in the patient's system.

Choice A rationale: While oral fluid intake is important for hydration and general health, it is not an immediate priority unless there is evidence of dehydration, which is not present here. The client’s main issues are urinary symptoms and infection.

Choice B rationale: Urinalysis results showing cloudy appearance, foul odor, and elevated pH indicate a urinary tract infection (UTI), which requires immediate follow-up due to the risk of sepsis and worsening infection if untreated. Normal urine should be clear, aromatic, and have a pH of 4.6–8.0.

Choice C rationale: The client’s report of burning sensation upon urination is a classic symptom of a UTI. Dysuria, urgency, and frequency are concerning signs of infection that require prompt medical attention to prevent complications such as pyelonephritis or bacteremia.

Choice D rationale: While the amber yellow color of urine is within normal range, the associated symptoms and laboratory findings are more concerning. The color alone does not indicate an immediate issue compared to the urinalysis and reported urinary discomfort.