The nurse is preparing a discharge teaching plan for a patient who is taking ciprofloxacin hydrochloride tablets due to suspected anthrax exposure.
What instructions should be included in the teaching plan?

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

Glucagon should not be administered before meals to prevent hyperglycemia. Glucagon is a hormone that raises blood glucose levels and is used to treat severe hypoglycemia. It is not intended to prevent hyperglycemia.

Choice B rationale

Glucagon should be administered when signs of severe hypoglycemia occur. Hypoglycemia, or low blood sugar, can cause symptoms such as confusion, dizziness, hunger, and shakiness. If left untreated, severe hypoglycemia can lead to unconsciousness or seizures.

Choice C rationale

Glucagon should not be administered when unable to eat during sick days. While it’s important to maintain blood glucose levels during illness, glucagon is specifically used for severe hypoglycemia.

Choice D rationale

Glucagon should not be administered at the onset of signs of diabetic ketoacidosis. Diabetic ketoacidosis is a serious condition that requires immediate medical attention. Glucagon is not a treatment for this condition.