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

Two hours after completion of the IV dose and two hours before the next administration of the medication.

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

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

choice A, Drawing the peak level two hours after the IV dose is too late to capture the drug's highest serum concentration. Similarly, drawing the trough two hours before the next dose does not reflect the lowest drug level accurately.
Choice B, Drawing the peak level one hour after completion of the IV dose ensures an accurate measurement of the highest serum concentration, as vancomycin typically peaks within this time frame. Drawing the trough one hour before the next dose ensures the lowest concentration of the drug is measured, providing precise therapeutic monitoring.

Choice C is incorrect because drawing blood 30 minutes into the IV dose would not allow the full dose to circulate and reach peak levels in the bloodstream.

Choice D. Drawing the peak level immediately after the completion of the IV dose is too early, as the drug needs time to distribute in the bloodstream and reach its highest concentration. While drawing the trough 30 minutes before the next dose is appropriate, the incorrect timing of the peak makes this option unsuitable.

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Correct Answer is D

Explanation

Choice A rationale: This instruction is not directly related to spironolactone use or hyperaldosteronism. Excessive bruising may be relevant in some situations but not specifically for this scenario.
Choice B rationale: While heart failure patients are often advised to reduce their sodium intake, the use of a salt substitute (potassium-based) would be contraindicated in this case due to the risk of hyperkalemia.
Choice C rationale: This instruction is not directly related to spironolactone use or
hyperaldosteronism. It may be relevant for sun protection, but it is not a priority in this context.
Choice D rationale: Spironolactone is a potassium-sparing diuretic, which means it helps the body retain potassium while excreting sodium and water. Since the client has heart failure (HF), there is a risk of hyperkalemia (high potassium levels) associated with spironolactone use. To prevent this, the nurse should instruct the client to limit their intake of high-potassium foods, such as bananas, oranges, tomatoes, spinach, and other potassium-rich foods.

A. administer IV lorazepam B. lower the client to the floor C. allow the client to seize for up to 10 minutes D. call a code

Correct Answer is A

No explanation

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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