A nurse is caring for a client who has a fungal infection and has a new prescription for amphotericin
Which of the following laboratory values should the nurse report to the provider before initiating the medication?

The correct answer is Choice C.

Let’s go through the calculation step by step:

Step 1: Identify the order and the available medication. The order is for dexamethasone (Decadron) 6mg IM. The available stock is dexamethasone 4mg/1ml in a 5ml multidose vial.

Step 2: Determine the amount of medication needed to fulfill the order. This is done by dividing the ordered amount by the concentration of the available medication.

So, we have:

Step 2 Calculation=Concentration of Available MedicationOrdered Amount Substituting the given values: Step 2 Calculation=4 mg/mL6 mg Step 3: Perform the calculation.

Step 3 Calculation=1.5 mL

So, the nurse will prepare 1.5 mL of this medication.

Now, let’s discuss the rationales for each choice:

Choice A rationale:

75 mLs is not the correct amount. This would be a significantly larger dose than ordered, which could lead to an overdose.

Choice B rationale:

5 mLs is not the correct amount. This would also be a larger dose than ordered, which could lead to an overdose.

Choice C rationale:

1.5 mLs is the correct amount. This is calculated by dividing the ordered dose (6 mg) by the concentration of the available medication (4 mg/mL).

Choice D rationale:

15 mLs is not the correct amount. This would be a significantly larger dose than ordered, which could lead to an overdose.

Choice A rationale:

Sodium levels in the blood are typically between 135 and 145 milliequivalents per liter (mEq/L). A sodium level of 140 mEq/L falls within this range, indicating normal sodium levels. Sodium plays a key role in your body. It helps maintain normal blood pressure, supports the work of your nerves and muscles, and regulates your body’s fluid balance. A normal sodium level is therefore crucial for the body’s overall function.

Choice B rationale:

A glucose level of 120 mg/dL is considered normal for a fasting blood sugar test. Glucose is your body’s main source of energy. It comes from the food you eat and is carried through your bloodstream to the cells of your body. If the glucose level in the blood is too high or too low, it can indicate a medical condition such as diabetes.

Choice C rationale:

Potassium levels in the blood are typically between 3.6 and 5.2 millimoles per liter (mmol/L). A potassium level of 4.5 mEq/L falls within this range, indicating normal potassium levels. Potassium is a type of electrolyte that is vital to the function of nerve and muscle cells, including those in your heart. Your blood potassium level is normally 3.6 to 5.2 millimoles per liter (mmol/L). Having a blood potassium level higher than 6.0 mmol/L can be dangerous and usually requires immediate treatment.

Choice D rationale:

The Blood Urea Nitrogen (BUN) test is a routine test used to assess kidney function. Urea nitrogen is a waste product that’s created in your liver when the body breaks down proteins. Healthy kidneys filter urea nitrogen from your blood, but when your kidneys aren’t working well, the BUN level rises. The normal range for BUN is typically around 7-20 mg/dL2. A BUN level of 55 mg/dL is significantly higher than the normal range, indicating that the kidneys may not be functioning properly. This is a critical finding that should be reported to the provider before initiating the medication amphotericin B. Amphotericin B is an antifungal medication used to treat serious, life-threatening fungal infections. However, it is known for its severe and potentially lethal side effects, including kidney damage. Therefore, a high BUN level should be reported to the provider before initiating this medication.