The nurse is caring for a client who needs to have a peak drug level drawn. The client was given an oral medication 30 minutes ago. What is the best action by the nurse?

Wait for at least another 30 minutes before calling to have the level drawn.

Schedule the level to be drawn in 8 hours

Call the lab to have the medication level drawn immediately

Arrange for the level to be drawn tomorrow since the peak time has passed.

Answer and Explanation

The Correct Answer is A

A. Wait for at least another 30 minutes before calling to have the level drawn:
For oral medications, peak drug levels are typically drawn 1 to 2 hours after administration, depending on the medication's pharmacokinetics. Since the client took the medication only 30 minutes ago, it is premature to draw the level now. Waiting an additional 30 minutes would align with the typical peak times for oral medications, ensuring that the drug level reflects its peak concentration.

B. Schedule the level to be drawn in 8 hours:
Drawing the peak level 8 hours after administration would likely be too late, as most oral medications reach their peak concentration within 1 to 2 hours. Scheduling the level for 8 hours later may result in an inaccurate measurement of the peak drug level, leading to potentially misleading clinical information.

C. Call the lab to have the medication level drawn immediately:
Drawing the level immediately after 30 minutes may not provide an accurate representation of the peak drug level. Oral medications generally reach peak levels later, and an early draw could result in a falsely low measurement that does not reflect the drug's maximum concentration.

D. Arrange for the level to be drawn tomorrow since the peak time has passed:
The peak time has not passed, as the medication was only administered 30 minutes ago. Drawing the level tomorrow would be far too late to assess the peak concentration accurately, which is essential for evaluating the effectiveness and safety of the medication.

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Correct Answer is B

Explanation

A) Inject a volume of less than 2 mL: While it is generally recommended to inject a volume of less than 2 mL into the deltoid muscle to avoid discomfort and ensure proper absorption, this is not the primary action to focus on when planning the injection.

B) Inject the medication at a 90 degree angle: This is the correct action. Administering an intramuscular (IM) injection at a 90-degree angle ensures that the medication is delivered deep into the muscle tissue, which is necessary for proper absorption and effectiveness.

C) Inject the medication 12.7 cm (5 in) below the client’s acromion process: The correct injection site for the deltoid muscle is typically 2-3 finger widths (approximately 2.5-5 cm) below the acromion process, not 12.7 cm. Injecting too far below the acromion process could result in an incorrect injection site.

D) Use a 21-gauge needle for the injection: While a 21-gauge needle can be used for IM injections, the gauge of the needle is not the primary focus in this context. The angle of injection is more critical to ensure proper delivery of the medication.

A. Absorption B. Excretion C. Metabolism D. Distribution

Correct Answer is C

Explanation

A. Absorption:
Chronic liver failure primarily affects the metabolism of drugs rather than their absorption. While liver disease can impact various bodily functions, the absorption of medications is generally more influenced by gastrointestinal factors and not as directly affected by liver function.

B. Excretion:
Excretion of drugs is primarily managed by the kidneys, not the liver. While liver failure can lead to changes in drug metabolism, it does not directly impair the excretion process, which is largely renal. However, compromised liver function can indirectly affect renal excretion due to altered pharmacokinetics.

C. Metabolism:
Liver failure significantly affects drug metabolism. The liver is the primary site for the metabolism of many medications, converting drugs into more water-soluble compounds for excretion. In chronic liver failure, the liver's ability to metabolize drugs is impaired, leading to potential drug accumulation and increased risk of toxicity. This step of pharmacokinetics is most directly impacted by liver dysfunction.

D. Distribution:
While liver function can affect drug distribution to some extent, it is not as directly impacted as metabolism. Distribution can be influenced by factors such as changes in plasma protein levels and blood flow, but the liver's primary role in drug metabolism is more directly affected by chronic liver failure.

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The nurse is caring for a client who needs to have a peak drug level drawn. The client was given an oral medication 30 minutes ago. What is the best action by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning to administer an IM injection into a client's deltoid muscle. Which action should the nurse take?

Correct Answer is B

Explanation

A client presents to the healthcare setting with a diagnosis of chronic liver failure. The nurse understands this will affect which step of pharmacokinetics?

Correct Answer is C

Explanation

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