The nurse is caring for a patient who is receiving an intravenous antibiotic. The patient has a serum drug trough of 1.5 mcg/mL. The normal trough for this drug is 1.7 to 2.2 mcg/mL. What will the nurse expect the patient to experience?
inadequate therapeutic effects
Excessive adverse effects
Signs of drug toxicity
Increased risk for superinfection
The Correct Answer is A
A. inadequate therapeutic effects: A trough level below the therapeutic range indicates insufficient drug concentration in the blood. This may result in the antibiotic being less effective at eliminating the infection, potentially delaying recovery.
B. Excessive adverse effects: Low trough levels reduce the risk of adverse effects rather than causing them. Toxicity and side effects are more likely with elevated drug levels, not subtherapeutic levels.
C. Signs of drug toxicity: Toxicity occurs when drug levels exceed the upper therapeutic limit, not when they are below range. A trough of 1.5 mcg/mL is subtherapeutic, so toxicity is unlikely.
D. Increased risk for superinfection: While prolonged ineffective therapy may increase infection complications over time, the immediate concern with a low trough is inadequate antimicrobial activity rather than direct development of superinfections.
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Related Questions
Correct Answer is A
Explanation
A. glucagon: In an unconscious patient with type 1 diabetes, hypoglycemia is a likely cause of altered consciousness. Glucagon raises blood glucose by stimulating glycogen breakdown in the liver, providing rapid correction when the patient cannot safely swallow oral carbohydrates. Prompt administration prevents further neurologic compromise.
B. orange juice: Oral glucose sources like juice are ineffective and unsafe in an unconscious patient because they cannot swallow, increasing the risk of aspiration. Administration requires the patient to be alert and able to safely ingest liquids.
C. insulin: Insulin lowers blood glucose and would worsen hypoglycemia in an unconscious diabetic patient. Administering insulin in this scenario could lead to severe neurologic injury or death.
D. cardiopulmonary resuscitation (CPR): CPR is indicated only if the patient is pulseless or not breathing adequately. Since this patient has a pulse and the immediate concern is hypoglycemia, CPR is not the appropriate intervention at this time.
Correct Answer is B
Explanation
A. parkinsonism: Atropine-like drugs may worsen certain symptoms such as confusion, but they are not absolutely contraindicated in parkinsonism. Some anticholinergic agents are even used to reduce tremors, so this condition does not represent the primary concern.
B. glaucoma: These drugs increase intraocular pressure by causing pupil dilation, which can obstruct aqueous humor outflow. In clients with glaucoma—especially narrow-angle—this can trigger dangerous pressure elevations and worsen vision rapidly.
C. peptic ulcer: Anticholinergics may slow gastric motility, but they do not directly worsen ulcer pathology. Although used cautiously, they are not considered strictly contraindicated in peptic ulcer disease.
D. cirrhosis: Liver disease requires careful medication management, yet atropine-like drugs do not pose a specific prohibitive risk. They may need dose adjustment, but cirrhosis is not a direct contraindication to their use.
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