A nurse is preparing to administer a medication that is highly protein bound.What should be considered when administering this drug to a client with hypoalbuminemia?

The client may have an increased free fraction of the drug

The client may have a decreased free fraction of the drug

The client may have an increased volume of distribution for the drug

The client’s albumin levels do not affect pharmacokinetics

Answer and Explanation

The Correct Answer is A

Medications that are highly protein bound bind to plasma proteins such as albumin, reducing their free fraction and potentially reducing their therapeutic effect.A client with hypoalbuminemia may have an increased free fraction of a highly protein-bound medication due to reduced protein binding, potentially increasing its therapeutic effect.

b.The client may have an increased, not decreased, free fraction of the drug due to reduced protein binding.

c.An increased volume of distribution may occur if protein binding is reduced, but this is not directly related to hypoalbuminemia.

d.The client’s albumin levels can affect pharmacokinetics by altering protein binding of highly protein-bound medications.

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Correct Answer is B

Explanation

A medication with a narrow therapeutic index has a small margin of safety between its therapeutic and toxic doses. The nurse should hold the medication and notify the provider to ensure that the client’s drug levels are within the therapeutic range and to avoid potential toxicity.

a. Administering the medication as prescribed could result in toxicity if the client’s drug levels are not within the therapeutic range.

c. Administering half the dose of the medication is not appropriate without consulting the provider and monitoring the client’s drug levels.

d. Administering the medication with food or milk may affect its absorption but does not prevent potential toxicity.

A. There is an increased risk of drug interactions B. There is a decreased risk of drug interactions C. There is no risk of drug interactions D. P-glycoprotein inhibition does not affect pharmacokinetics

Correct Answer is A

Explanation

P-glycoprotein is a membrane protein that pumps certain drugs out of cells and can affect their absorption, distribution, and elimination. Inhibition of P-glycoprotein can increase the concentration of other medications that are substrates for this protein, potentially increasing their therapeutic effect and the risk of drug interactions.

b. There is an increased, not decreased, risk of drug interactions due to increased concentration of other medications that are substrates for P-glycoprotein.

c. There is an increased risk of drug interactions due to increased concentration of other medications that are substrates for P-glycoprotein.

d. P-glycoprotein inhibition can affect pharmacokinetics by altering absorption, distribution, and elimination of other medications that are substrates for this protein.

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A nurse is preparing to administer a medication that is highly protein bound.What should be considered when administering this drug to a client with hypoalbuminemia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer a medication that has a narrow therapeutic index. What action should the nurse take?

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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