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.

None

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 A

Explanation

Choice A rationale: Heartburn when lying down after dinner can be a symptom of gastroesophageal reflux disease (GERD), which is a common concern in individuals with heart failure. Antacids are commonly used to relieve heartburn by neutralizing stomach acid. For patients with heart failure, it is essential to use low sodium antacids because excess sodium intake can worsen fluid retention and lead to increased heart failure symptoms. Low sodium antacids are specifically designed to minimize the sodium content, making them a suitable choice for individuals with heart failure.

Choice B rationale: Diphenhydramine is an antihistamine commonly used for allergy relief and as a sleep aid due to its sedative effects. However, it is not an appropriate choice for relieving heartburn. Diphenhydramine does not have any direct effect on stomach acid, and it is not indicated for GERD or heartburn relief.

Choice C rationale: Low dose aspirin is primarily used as an antiplatelet agent to reduce the risk of blood clots and is commonly prescribed for patients with certain cardiovascular conditions. However, it is not a suitable medication for relieving heartburn. In fact, aspirin can irritate the stomach lining and worsen symptoms of heartburn and gastric irritation.

Choice D rationale: Acetaminophen is a common over-the-counter pain reliever and fever reducer. While it is useful for managing pain and fever, it does not have any effect on stomach acid and is not indicated for heartburn relief. Acetaminophen is not an appropriate choice for addressing heartburn symptoms.

A. Serum ammonia level of 30 Mcg/dL (17.62 Mcmol /dL). B. Serum potassium level of 3.8 mEq/L (3.8 mmol/L). C. Serum glucose level of 120 mg/dL (6.7 mmol/L). D. Hemoglobin level of 13.5 g/dL (135 g/L).

Correct Answer is B

Explanation

Choice A rationale: Serum ammonia levels are not relevant to the effectiveness of sodium polystyrene sulfonate in treating hyperkalemia.

Choice B rationale: Sodium polystyrene sulfonate is a medication used to treat hyperkalemia (high potassium levels). A serum potassium level of 3.8 mEq/L falls within the normal reference range (3.5 to 5.0 mEq/L), indicating that the medication has been effective in promoting the excretion of potassium and reducing hyperkalemia.

Choice C rationale: Serum glucose levels are not relevant to the effectiveness of sodium polystyrene sulfonate in treating hyperkalemia.

Choice D rationale: Hemoglobin levels are not relevant to the effectiveness of sodium polystyrene sulfonate in treating hyperkalemia.

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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?

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Naxlex Comprehensive Predictor Exams

A male client with a history of heart failure (HF) complains of heartburn when he lies down after dinner. The home health nurse should encourage the client to talk to the healthcare provider about using which over-the-counter medication to relieve this problem?

Correct Answer is A

Explanation

Correct Answer is B

Explanation

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