A patient who is taking albendazole reports experiencing fatigue, nausea, and dark urine. The nurse observes a yellowing of the patient’s skin and sclera.
Which laboratory result should the nurse review?

The correct answer is D. Immediately after completion of the IV dose and 30 minutes before the next administration of the medication.

Explanation:

• Peak levels measure the highest concentration of the drug in the bloodstream, typically drawn immediately after completion of the infusion.

• Trough levels measure the lowest concentration, typically drawn 30 minutes before the next scheduled dose to ensure effective drug levels while preventing toxicity.

Why the other options are incorrect:

• A. One hour after completion of the IV dose and one hour before the next administration – Waiting one hour for the peak level could lead to an inaccurate measurement, as the drug may already be metabolized or distributed.

• B. Two hours after completion of the IV dose and two hours before the next administration – This timing is too late for both peak and trough levels, missing the best points for measurement.

• C. Thirty minutes into the administration of the IV dose and 30 minutes before the next administration – The sample drawn mid-infusion does not represent peak levels, making this method ineffective.

Key takeaway:

Peak and trough monitoring for vancomycin is essential to maximize effectiveness while avoiding nephrotoxicity and ototoxicity. Proper timing ensures accurate therapeutic drug monitoring.

Choice A rationale

Filgrastim is a medication used to stimulate the growth of white blood cells, making patients less vulnerable to infections. If the patient’s white blood cell count has increased from 2,500/mm^3 to 5,000/mm^3 after administering five doses of filgrastim, it indicates that the medication has been effective.

Choice B rationale

Reviewing the patient’s culture and sensitivity reports is not directly related to the effect of filgrastim on white blood cell count.

Choice C rationale

Neutropenic precautions are typically implemented when a patient has a low white blood cell count. Since the patient’s white blood cell count has increased, implementing neutropenic precautions may not be necessary.

Choice D rationale

While it’s always important to monitor a patient’s vital signs, there’s no specific reason to do so just because the patient’s white blood cell count has increased after administering filgrastim.