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

Immediately after completion of the IV dose and 30 minutes 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.

Two hours after completion of the IV dose and two hours 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.

Answer and Explanation

The Correct Answer is A

A. Immediately after completion of the IV dose and 30 minutes before the next administration of the medication: This timing is correct for monitoring vancomycin levels. The peak level is typically measured immediately after the completion of the infusion (though peak levels are less commonly required for vancomycin), and the trough level is measured just before the next dose is due, 30 minutes before administration. This approach helps in evaluating the medication's efficacy and safety.
B. One hour after completion of the IV dose and one hour before the next administration of the medication: This timing is not ideal. The peak level for vancomycin is usually measured immediately after the dose rather than one hour later. Trough levels are measured closer to the next dose, typically 30 minutes before the next dose.
C. Two hours after completion of the IV dose and two hours before the next administration of the medication: Measuring levels two hours after the dose completion is too late for a peak level. The trough level should be measured closer to the next dose, generally 30 minutes before the next administration.
D. Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication: Measuring the level 30 minutes into the infusion is not appropriate for peak levels, which are typically measured.

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Correct Answer is C

Explanation

A. Diabetes mellitus: While diabetes mellitus is an important condition to consider for overall health, it is not directly related to the use of magnesium hydroxide and aluminum hydroxide, as these antacids primarily affect the gastrointestinal system and renal function.
B. Deep vein thrombosis: Deep vein thrombosis is related to blood clot formation and does not have a direct connection to the use of magnesium and aluminum hydroxide, which affect the gastrointestinal system and renal function.
C. Renal disease: Magnesium hydroxide and aluminum hydroxide can affect kidney function and cause complications in individuals with renal disease. Magnesium and aluminum are excreted through the kidneys, and impaired renal function can lead to an accumulation of these substances, causing potential toxicity.
D. Chronic bronchitis: Chronic bronchitis affects the respiratory system and is not directly impacted by the use of magnesium and aluminum hydroxide, which are primarily concerned with gastrointestinal and renal function.

A. Gout. B. Sepsis. C. Myocardial infarction. D. Rheumatoid arthritis.

Correct Answer is C

Explanation

A. Gout: Aspirin is not typically used for treating gout. Gout is commonly treated with medications like allopurinol or colchicine, and nonsteroidal anti-inflammatory drugs (NSAIDs) are used selectively.
B. Sepsis: Aspirin is not a primary treatment for sepsis. Sepsis is usually treated with antibiotics, fluid resuscitation, and supportive care.
C. Myocardial infarction: Aspirin is beneficial for preventing further myocardial infarctions (heart attacks) in patients with a history of cardiovascular events or at high risk. It works by inhibiting platelet aggregation, thereby reducing the risk of blood clot formation that can lead to heart attacks.
D. Rheumatoid arthritis: Although aspirin can be used for symptomatic relief in rheumatoid arthritis due to its anti-inflammatory properties, it is not the primary treatment. Other medications, such as disease-modifying antirheumatic drugs (DMARDs) and nonsteroidal anti-inflammatory drugs (NSAIDs), are typically used.

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

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