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","B","C","D","E","F"]
No explanation
Correct Answer is C
Explanation
Choice A rationale: Nausea is the symptom the medication is intended to treat, and it is expected that the client may have some level of nausea while undergoing chemotherapy. It is not the most important adverse effect to report in this scenario.
Choice B rationale: Diarrhea is not a common or significant adverse effect of metoclopramide. While it is essential to monitor for any gastrointestinal side effects, it is not the most important adverse effect to report in this case.
Choice C rationale: Metoclopramide is a medication commonly used to treat nausea and vomiting, particularly related to chemotherapy. One of the significant adverse effects of metoclopramide is the potential to cause extrapyramidal symptoms, including involuntary movements such as dystonia, dyskinesia, and Parkinsonism. These extrapyramidal symptoms can be serious and may require immediate intervention or discontinuation of the medication.
Therefore, it is essential for the nurse to closely monitor the client for any signs of involuntary movements and report them promptly to the healthcare provider for appropriate management.
Choice D rationale: Unusual irritability is not a typical adverse effect associated with metoclopramide. While mood changes can occur with any medication, involuntary movements are a more concerning side effect that requires immediate attention and reporting.
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