A nurse is preparing to administer vancomycin, a glycopeptide antibiotic, to a client with a severe infection caused by Clostridium difficile.
The nurse should select all that apply:
Monitor the client’s serum creatinine level
Monitor the client’s serum vancomycin level
Infuse the drug over at least 60 minutes
Observe the client
Correct Answer : A,B,C
Here is why:
• Choice A: Monitor the client’s serum creatinine level.
This is correct because vancomycin can cause nephrotoxicity (damage to the kidneys) and serum creatinine is a marker of kidney function. A high serum creatinine level indicates impaired kidney function and may require dose adjustment or discontinuation of vancomycin.
• Choice B: Monitor the client’s serum vancomycin level.
This is correct because vancomycin has a narrow therapeutic range, meaning that there is a small difference between the effective dose and the toxic dose. Monitoring the serum vancomycin level can help to ensure that the drug is within the therapeutic range and avoid toxicity or suboptimal efficacy.
• Choice C: Infuse the drug over at least 60 minutes.
This is correct because vancomycin can cause a hypersensitivity reaction called “red man syndrome” or “red neck syndrome”, which is characterized by flushing, itching, rash, hypotension and tachycardia.
This reaction is not an allergy but a result of histamine release due to rapid infusion of vancomycin. Infusing the drug over at least 60 minutes can reduce the risk of this reaction.
• Choice D: Observe the client for signs of ototoxicity.
This is incorrect because vancomycin is not known to cause ototoxicity (damage to the ears) in humans. Ototoxicity has been reported in animal studies and in vitro studies, but not in clinical trials or case reports involving humans.
Therefore, there is no need to monitor for signs of ototoxicity such as hearing loss, tinnitus or vertigo.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D"]
Explanation
The nurse should include these instructions in the teaching because:
• Tetracycline should be taken on an empty stomach to avoid interference with absorption.
• Dairy products should be avoided while taking this drug because they contain calcium, which can form insoluble complexes with tetracycline and reduce its effectiveness.
• Sunscreen or sun avoidance should be used while taking this drug because it can cause photosensitivity, which increases the risk of sunburn and skin damage.
• Plenty of fluids should be drunk while taking this drug because it can cause nephrotoxicity, which is damage to the kidneys.
Choice E is wrong because vaginal itching or discharge is not a common side effect of tetracycline.It may indicate a superinfection, which is a secondary infection caused by the disruption of normal flora by antibiotics.
This should be reported to the health care provider as soon as possible.
Correct Answer is A
Explanation
Maraviroc is aCCR5 coreceptor antagonistthat blocks the receptor site the HIV virus needs to interact with in order to enter the cell.It prevents viral fusion with host cell membrane by binding to the CCR5 receptor on CD4+ T cells and macrophages.
Choice B is wrong becauseAbacavir is wrong because it is anucleoside reverse transcriptase inhibitor (NRTI)that inhibits the enzyme reverse transcriptase, which converts viral RNA into DNA.
It does not prevent viral fusion with host cell membrane.
Choice C is wrong becauseDarunavir is wrong because it is aprotease inhibitor (PI)that inhibits the enzyme protease, which cleaves viral proteins into functional units.
It does not prevent viral fusion with host cell membrane.
Choice D is wrong becauseFosamprenavir is wrong because it is also aprotease inhibitor (PI)that inhibits the enzyme protease.
It does not prevent viral fusion with host cell membrane.
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