A client is receiving intravenous (1V) vancomycin and the nurse plans to draw blood for a peak a. trough to determine the serum level of the drug. Which collection times provide the best determination of these levels?

Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication.

Two hours after completion of the IV dose 2nd 00 0000 before the next administration of the medication.

One how after completion of the IV dose and one hour before the next administration oldie medication.

Immediately after completion of the IV dose and 30 minutes before the next administration of the medication.

Answer and Explanation

The Correct Answer is D

A. Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication:

This timing doesn't align with the standard practice of drawing peak levels immediately after the IV dose is completed.

The trough level should be taken just before the next dose, not 30 minutes before.

B. Two hours after completion of the IV dose and 1 hour before the next administration of the medication:

Waiting for two hours after the dose to draw the peak level is too long. Peak levels are typically drawn immediately after completion.

Drawing the trough level one hour before the next dose doesn't provide an accurate assessment of the lowest drug concentration just before the next administration.

C. One hour after completion of the IV dose and one hour before the next administration of the medication:

Similar to choice B, waiting one hour after the dose to draw the peak level is not in line with standard practice.

Drawing the trough level one hour before the next dose is administered is too early to accurately represent the lowest concentration.

The best collection times for determining the peak and trough levels of intravenous (IV) vancomycin are:

D. Immediately after completion of the IV dose and 30 minutes before the next administration of the medication.

Explanation:

Peak Level: Peak levels of vancomycin are drawn immediately after the completion of the IV dose. This is done to assess the highest concentration of the drug in the bloodstream, which is important for ensuring its therapeutic efficacy and monitoring for potential toxicity.

Trough Level: Trough levels are drawn just before the next dose is administered. A trough level represents the lowest concentration of the drug in the bloodstream, ensuring that the drug is still present at a therapeutic level before the next dose is given. Taking the trough level 30 minutes before the next administration is appropriate, as it allows time for the drug to reach its lowest concentration before receiving the next dose.

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Correct Answer is B

Explanation

A. Take with milk or antacids to prevent gastrointestinal (GI) irritation:

Tetracycline should not be taken with milk or antacids because these can bind to the medication and reduce its absorption. It is generally recommended to take tetracycline with a full glass of water on an empty stomach, unless otherwise instructed by the healthcare provider.

When providing instructions to a client prescribed tetracycline HCl, the nurse should include the following instruction:

B. Protect the skin from sunlight while taking the drug.

Explanation: Tetracycline antibiotics can make the skin more sensitive to sunlight (photosensitivity). Exposure to sunlight or ultraviolet (UV) rays can lead to severe sunburn reactions. Therefore, it is important for clients taking tetracycline to avoid prolonged exposure to direct sunlight and to use sunblock, protective clothing, and sunglasses when outdoors. This precaution helps prevent skin irritation and sunburn.

C. Return to the clinic weekly to obtain serum drug levels:

Routine monitoring of serum drug levels is not typically required for clients taking tetracycline. Monitoring may be necessary for other medications, but it is not a standard practice for tetracycline.

D. Take with orange juice to enhance GI absorption:

Like milk and antacids, taking tetracycline with orange juice can interfere with its absorption. It is generally recommended to take tetracycline with a full glass of water on an empty stomach for optimal absorption.

A. Ask the client to rate the current level of pain using a pain scale. B. Review the history for a past use of recreational drugs. C. Encourage the client to use diversional thoughts to manage pain. D. Determine when the last dose was administered.

Correct Answer is A

Explanation

When a client in the surgical recovery area asks for the largest possible dose of pain medication, the nurse should implement the following action first:

A. Ask the client to rate the current level of pain using a pain scale.

Explanation: Before administering pain medication, it is essential to assess the client's current level of pain. Using a pain scale allows the nurse to understand the severity of the pain and tailor the medication dosage accordingly. This assessment helps ensure that the client receives an appropriate and safe dose of pain medication.

Why the other choices are not the first action to take:

B. Review the history for a past use of recreational drugs:

While assessing a client's history, including past drug use, is important, it is not the immediate priority when a client is requesting pain medication. Pain assessment and management should come first.

C. Encourage the client to use diversional thoughts to manage pain:

Diversional thoughts and non-pharmacological pain management strategies can be helpful, but they should not be the initial response when a client is in acute pain and requesting medication.

D. Determine when the last dose was administered:

While it is important to know when the last dose of pain medication was given, this information is typically obtained after assessing the client's current pain level. Assessing pain intensity and then reviewing medication history and administration times is a logical sequence of actions.

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A client is receiving intravenous (1V) vancomycin and the nurse plans to draw blood for a peak a. trough to determine the serum level of the drug. Which collection times provide the best determination of these levels?

Nursing Test Bank

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