A patient has a urinary tract infection.
The nurse knows that which class of drugs is especially useful for such infections?

Choice A rationale:

Holding the drug and administering it 4 hours later is not the appropriate action. The trough vancomycin level of 24 mcg/mL is higher than the recommended range of 10-20 mcg/mL, indicating potential risk for toxicity. Administering the drug later does not address the immediate concern of a high trough level.

Choice B rationale:

Administering the vancomycin as ordered is not the correct action in this case. The trough level is above the recommended range, which could lead to vancomycin toxicity. The nurse should not administer the medication without addressing the high trough level. Choice C rationale:

This is the correct action. The nurse should hold the drug and notify the prescriber because the trough vancomycin level is higher than the recommended range. The prescriber can then make a decision based on this information, which may include adjusting the dose, extending the dosing interval, or ordering additional tests.

Choice D rationale:

While repeating the test to verify results might be done eventually, it should not be the immediate next step. The nurse has a responsibility to ensure patient safety, and with a trough level above the recommended range, the priority is to prevent potential toxicity. Therefore, the nurse should hold the drug and notify the prescriber.

Choice A rationale:

Insulin is not absorbed most rapidly when injected in the thigh. The abdomen is actually the preferred site for insulin injection as insulin is absorbed more quickly and predictably there. The thigh is a simple area for self-injection, but regular injections in the thigh can sometimes cause discomfort when walking or running afterward.

Choice B rationale:

Using cold insulin for injection to minimize site pain is not recommended. Insulin should be at room temperature. Cold insulin might make the injection more painful.

Choice C rationale:

Massaging the site after injection to promote absorption is not advised. It can cause the insulin to be absorbed too quickly which can lead to low blood glucose levels.

Choice D rationale:

Rotating the injection site to keep insulin levels consistent is the correct choice. People who take insulin daily should rotate their injection sites. This is important because using the same spot over time can cause lipodystrophy. In this condition, fat either breaks down or builds up under the skin, causing lumps or indentations that interfere with insulin absorption.