A nurse is reviewing the medical record of a client who is receiving vancomycin daily. The nurse should review which of the following laboratory results prior to administering the next dose?
Thyroid-stimulating hormone level
Blood glucose level
Total iron-binding count
BUN level
The Correct Answer is D
A. Thyroid-stimulating hormone level: TSH levels are used to assess thyroid function and are not affected by vancomycin therapy. Monitoring TSH is unrelated to safe administration of this antibiotic.
B. Blood glucose level: Blood glucose monitoring is important for clients with diabetes or receiving medications that affect glucose, but it is not directly relevant to vancomycin dosing or toxicity.
C. Total iron-binding count: Total iron-binding capacity reflects iron status and is unrelated to vancomycin therapy. It does not influence dosing or safety considerations for this antibiotic.
D. BUN level: Vancomycin is nephrotoxic, and kidney function must be monitored to prevent accumulation and toxicity. Blood urea nitrogen (BUN) provides an indicator of renal function, and reviewing it prior to the next dose helps ensure safe administration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Heart rate of 56/min: Propranolol is a beta-blocker that can lower heart rate. A heart rate below 60/min may indicate bradycardia, which can be dangerous and requires intervention before administering the next dose.
B. SaO2 95% on 2 L/min of oxygen: Oxygen saturation of 95% on supplemental oxygen is within an acceptable range and does not require immediate intervention.
C. Blood pressure 106/68 mm Hg: While slightly on the lower side, this blood pressure is generally considered acceptable for many adults and does not typically necessitate an immediate intervention.
D. Respirations 22/min: A respiratory rate of 22/min is mildly elevated but usually not critical. It does not require withholding propranolol or immediate intervention in a stable client.
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"D"}
Explanation
Rationale for Correct Choices:
- Diltiazem: Diltiazem is a calcium channel blocker commonly used to control ventricular rate in atrial fibrillation. The client’s ECG confirms atrial fibrillation with rapid ventricular response, making rate control a priority to prevent hemodynamic instability.
- Cardiac rhythm: The rapid, irregular heart rate documented on ECG is the primary finding necessitating medication intervention to prevent further complications such as decreased cardiac output or thromboembolism.
Rationale for Incorrect Choices:
- Dopamine: Dopamine is a vasopressor used to support blood pressure in hypotension or shock. While the client’s BP is mildly decreased, the immediate concern is rapid atrial fibrillation rather than hypotensive crisis.
- Furosemide: Furosemide treats fluid overload and edema but does not directly address the acute arrhythmia causing tachycardia and hemodynamic compromise.
- Albuterol nebulizer: Albuterol is used for bronchospasm and respiratory distress related to airway constriction. The client has clear lung sounds, so this is not indicated.
- Alprazolam: Alprazolam can reduce anxiety but does not manage the underlying atrial fibrillation or prevent cardiovascular complications.
- Edema, blood pressure, anxiety, dyspnea: While these are relevant assessments, they are secondary to the urgent need to control the cardiac rhythm in acute atrial fibrillation.
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