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.
The Correct Answer is D
choice A, drawing blood two hours after the IV dose completion would miss the peak serum level of vancomycin, which typically occurs shortly after the dose is administered. This timing would not accurately reflect the highest concentration of the drug in the bloodstream.
Choice B, while closer to the peak, still may not capture the maximum serum level as the peak can occur within 30 minutes to 1 hour after administration.
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 is the most appropriate because drawing blood immediately after the IV dose completion captures the peak concentration, and drawing 30 minutes before the next dose captures the trough level, or the lowest concentration, right before the subsequent dose is given, providing a complete profile of the drug's serum levels.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
No explanation
Correct Answer is C
Explanation
a) Assess the client for side effects of carbamazepine:
- This option might seem reasonable as monitoring for side effects is essential with any medication, especially one with a narrow therapeutic range like carbamazepine. However, the client's level of 8.4 mcg/L is within the therapeutic range (4 to 12 mcg/mL), so there's no immediate indication that side effects are likely to occur solely based on this level.
b) Notify the healthcare provider of the carbamazepine level:
- While it's important to keep the healthcare provider informed about the client's condition, in this case, the carbamazepine level is within the therapeutic range. There's no urgent need to notify the provider unless there are other concerning factors not mentioned in the scenario.
c) Administer the carbamazepine as prescribed:
- This is the correct answer. The client's morning carbamazepine level of 8.4 mcg/L falls within the therapeutic range (4 to 12 mcg/mL). Therefore, the evening dose should be administered as prescribed to maintain therapeutic levels and control the client's condition.
d) Withhold this dose of the carbamazepine:
- Withholding the dose based solely on the morning carbamazepine level of 8.4 mcg/L, which is within the therapeutic range, would not be appropriate. Withholding the dose without consulting the healthcare provider could potentially lead to suboptimal management of the client's condition.
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