Which organ is primarily responsible for excretion of a medication?

Choice A reason: "Antibiotics are administered to treat viral infections." is an incorrect statement for the nurse to make when providing teaching for a client who has a new prescription for an antibiotic. Antibiotics are medicines that fight bacterial infections in people and animals. They work by killing the bacteria or by making it hard for the bacteria to grow and multiply. Antibiotics do not work against viruses, such as those that cause colds, flu, or COVID19. Taking antibiotics when they are not needed can cause harm and increase the risk of antibiotic resistance¹.

Choice B reason: "Bloody stools are expected while taking antibiotics." is an incorrect statement for the nurse to make when providing teaching for a client who has a new prescription for an antibiotic. Bloody stools are not a normal or expected side effect of antibiotics. They can indicate a serious condition, such as intestinal bleeding, ulcerative colitis, or Clostridioides difficile infection. C. diff is a type of bacteria that can cause severe diarrhea, abdominal pain, and bloody stools. It can occur when antibiotics disrupt the normal balance of bacteria in the gut and allow C. diff to grow and produce toxins. The nurse should instruct the client to report any signs of bloody stools or severe diarrhea to the health care provider immediately.

Choice C reason: "Take the entire course of antibiotics as prescribed." is a correct statement for the nurse to make when providing teaching for a client who has a new prescription for an antibiotic. Taking the entire course of antibiotics as prescribed is important to ensure that the infection is completely treated and to prevent the bacteria from becoming resistant to the antibiotic. Stopping the antibiotic too soon or skipping doses can allow some bacteria to survive and multiply, which can cause the infection to come back or spread to other parts of the body. The nurse should also remind the client to follow the instructions on the medication label or the prescriber's order regarding the dosage, frequency, and duration of the antibiotic therapy.

Choice D reason: "Discontinue the medication when you feel better." is an incorrect statement for the nurse to make when providing teaching for a client who has a new prescription for an antibiotic. Discontinuing the medication when the client feels better is not advisable, as it can lead to incomplete treatment and antibiotic resistance. Feeling better does not mean that the infection is gone or that the bacteria are all killed. The client should continue to take the antibiotic until the end of the prescribed course, even if they have no symptoms or feel better. The nurse should also advise the client to contact the health care provider if they have any questions or concerns about the antibiotic or if they experience any side effects or allergic reactions.

Choice A reason: Peak level is the correct term to describe the highest concentration of a drug in the blood after it is administered. Peak level is also known as peak plasma concentration or Cmax, and it reflects the rate and extent of drug absorption. Peak level is influenced by factors such as the route of administration, the dose, the formulation, and the bioavailability of the drug. Peak level is important to monitor for drugs that have a narrow therapeutic range, meaning that there is a small difference between the effective and toxic doses. The nurse should measure the peak level at the appropriate time after the drug administration, and adjust the dose or the frequency as needed to achieve the desired therapeutic effect and avoid adverse effects .

Choice B reason: Halflife is not the correct term to describe the highest concentration of a drug in the blood after it is administered. Halflife is the time it takes for the concentration of a drug in the blood to decrease by 50%. Halflife reflects the rate of drug elimination, which depends on factors such as the metabolism and excretion of the drug. Halflife is important to determine the dosing interval and the time to reach steady state. The nurse should consider the halflife of the drug when prescribing or administering the drug, and avoid drug accumulation or subtherapeutic levels .

Choice C reason: Trough level is not the correct term to describe the highest concentration of a drug in the blood after it is administered. Trough level is the lowest concentration of a drug in the blood before the next dose is given. Trough level reflects the balance between drug absorption and elimination, and it indicates the minimum effective concentration of the drug. Trough level is important to monitor for drugs that have a narrow therapeutic range, meaning that there is a small difference between the effective and toxic doses. The nurse should measure the trough level just before the next dose of the drug, and adjust the dose or the frequency as needed to achieve the desired therapeutic effect and avoid adverse effects .

Choice D reason: Steady state is not the correct term to describe the highest concentration of a drug in the blood after it is administered. Steady state is the condition when the rate of drug administration is equal to the rate of drug elimination, and the concentration of the drug in the blood remains constant. Steady state is usually reached after four to five halflives of the drug, and it reflects the optimal therapeutic level of the drug. Steady state is important to maintain for drugs that have a long halflife or a narrow therapeutic range, meaning that there is a small difference between the effective and toxic doses. The nurse should ensure that the drug is administered at regular intervals and at the appropriate dose to achieve and maintain steady state.