A peak and trough level was obtained from a client receiving an aminoglycoside IV every 8 hours. Which finding presents the highest risk for the client and should be reported immediately to the healthcare provider?

Decreased peak, decreased trough.

Decreased trough only.

Increased peak, increased trough.

Decreased peak only.

Answer and Explanation

The Correct Answer is C

A) A decreased peak and trough level may indicate subtherapeutic levels of the medication but do not pose an immediate risk to the client. Adjustments to the dosing regimen may be needed, but this finding does not require immediate action.

B) A decreased trough level alone may suggest a need for dosage adjustment but does not present an immediate risk to the client. It is important to monitor therapeutic drug levels, but this finding does not require immediate reporting to the healthcare provider.

C) An increased peak and trough level indicates potential toxicity of the medication. Increased peak levels can lead to nephrotoxicity, while increased trough levels can lead to ototoxicity. Both conditions are serious and require immediate action to prevent harm to the client. The nurse should report this finding immediately to the healthcare provider for further evaluation and possible adjustment of the medication regimen.

D) A decreased peak level alone may indicate subtherapeutic levels of the medication, but it does not pose an immediate risk to the client. Adjustments to the dosing regimen may be needed, but this finding does not require immediate action.

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Correct Answer is B

Explanation

A) Notify the healthcare provider of the contraindication to tetracyclines: Tetracyclines, including doxycycline hyclate, are not contraindicated in clients taking birth control pills. While there may be interactions between these medications, they are not absolute contraindications.

B) Advise the client that the oral birth control will be less effective while taking doxycycline hyclate: Doxycycline hyclate, like other antibiotics, may reduce the effectiveness of oral contraceptives by altering the gut flora and interfering with the enterohepatic circulation of estrogen. Clients should be informed of this potential interaction and advised to use an additional form of contraception (such as condoms) while taking the antibiotic and for a period afterward.

C) Instruct the client to take the two medications at least two hours apart: While separating the administration of doxycycline hyclate and oral contraceptives by two hours may reduce the potential for interaction, it is not the standard recommendation. It is generally advised to use additional contraceptive methods during antibiotic therapy and for a period afterward, rather than relying solely on timing of medication administration.

D) Encourage the client to stop taking oral birth control until she has finished taking all the doxycycline hyclate: Stopping oral contraceptives abruptly is not recommended and may lead to unintended pregnancy. Instead, clients should be advised to use additional contraceptive methods while taking doxycycline hyclate and for a period afterward to ensure continued protection against pregnancy.

A. Take with a glass of milk. B. Use a straw to ingest. C. Swallow undiluted. D. Mix with an antacid.

Correct Answer is B

Explanation

A) Taking ferrous sulfate elixir with a glass of milk is not recommended because milk can interfere with the absorption of iron. Iron absorption is enhanced in an acidic environment, and milk's ca’cium content can inhibit this process.

B) Using a straw to ingest the ferrous sulfate elixir is advisable because it can help minimize contact between the medication and the teeth, reducing the risk of staining. Iron supplements can cause discoloration of the teeth, and using a straw directs the liquid towards the back of the mouth, bypassing the teeth.

C) Swallowing ferrous sulfate elixir undiluted is the usual method of administration; however, doing so may increase the risk of staining the teeth due to direct contact with the oral mucosa and teeth. It is important to follow the healthcare provider's in’tructions regarding dosage and administration.

D) Mixing ferrous sulfate elixir with an antacid is generally not recommended unless specifically directed by the healthcare provider. Antacids containing calcium or magnesium can bind to iron, forming complexes that are poorly absorbed in the gastrointestinal tract, thereby reducing the effectiveness of iron supplementation.

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A peak and trough level was obtained from a client receiving an aminoglycoside IV every 8 hours. Which finding presents the highest risk for the client and should be reported immediately to the healthcare provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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