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?

Choice A rationale: this is not an appropriate response because while it may reduce the intake of vitamin K, suddenly changing the client's diet drastically may not be necessary. It is essential for the healthcare provider to make any necessary adjustments to the medication based on the client's diet.

Choice B rationale: Warfarin is an anticoagulant medication that works by inhibiting the formation of blood clots. It interacts with vitamin K, which plays a crucial role in the blood clotting process. Leafy green vegetables are rich in vitamin K, and their consumption can affect the effectiveness of warfarin. The nurse should advise the client to inform her healthcare provider about her vegetarian diet and the regular consumption of leafy green vegetables. The healthcare provider will then be able to adjust the warfarin dosage accordingly to ensure that the client receives the appropriate and consistent level of anticoagulation.

Choice C rationale: while a vegetarian diet can be healthy, the specific concern here is the potential impact of vitamin K-rich foods on warfarin therapy. It's essential to address this potential interaction rather than focusing solely on the overall healthy lifestyle.

Choice D rationale: Consuming large amounts of leafy green vegetables and vitamin K-rich foods may actually reduce the effectiveness of warfarin, leading to a decreased ability to prevent blood clots. Therefore, it is crucial to consult with the healthcare provider to manage the dosage appropriately.

Choice A rationale: Non-steroidal anti-inflammatory drugs (NSAIDs) are a different class of
medications commonly used to relieve pain, inflammation, and reduce fever. They are not used
for treating hypertension or acting as ACE inhibitors.
Choice B rationale: Angiotensin II receptor blockers (ARBs) are another class of
antihypertensive medications that work by blocking the action of angiotensin II, a hormone that
causes blood vessels to constrict. While ARBs are similar in function to ACE inhibitors in
managing blood pressure, captopril specifically belongs to the ACE inhibitor class.
Choice C rationale: Captopril is an angiotensin-converting enzyme (ACE) inhibitor. ACE
inhibitors are a class of antihypertensive medications that work by inhibiting the enzyme ACE,
which converts angiotensin I to angiotensin II. By inhibiting this conversion, ACE inhibitors
help relax and dilate blood vessels, leading to decreased blood pressure. They are commonly
used to treat hypertension and other cardiovascular conditions.
Choice D rationale: Aldosterone antagonists are a different class of medications used to block the
action of aldosterone, a hormone that regulates sodium and water balance in the body. They are
used to manage conditions such as heart failure and hypertension but are not synonymous with ACE inhibitors like captopril.