A nurse is caring for a client who has recurrent kidney stones and a history of diabetes mellitus.
The client is scheduled for an intravenous Pyelogram (IVP). The nurse should collect additional data about which of the following statements made by the client?

Choice A rationale:

The statement “The intravenous medication will have delayed absorption into the body’s tissues” is incorrect. Intravenous (IV) therapy is administering fluids directly into a vein. It benefits treatment by enabling water, medication, blood, or nutrients to access the body faster through the circulatory system. This bypasses the gastric system so the body can take on more fluids quickly. Therefore, the absorption of intravenous medication into the body’s tissues is not delayed but rather immediate.

Choice B rationale:

The statement “The action of the medication will begin sooner when given intravenously” is correct. Administering a medication intravenously eliminates the process of drug absorption and breakdown by directly depositing it into the blood. This results in the immediate elevation of serum levels and high concentration in vital organs, such as the heart, brain, and kidneys. Therefore, the action of the medication begins sooner when given intravenously.

Choice C rationale:

The statement “The medication will cause fewer adverse effects when given intravenously” is not necessarily true. While some medications might cause fewer adverse effects when given intravenously, this is not a general rule for all medications. The adverse effects of a medication depend on various factors including the type of medication, the dose, the patient’s health condition, and more.

Choice D rationale:

The statement “There is a lower chance of allergic reactions when drugs are given intravenously” is not necessarily true. The chance of allergic reactions depends on various factors including the type of drug, the patient’s immune response, previous exposure to the drug, and more. It’s not related to the route of administration.

Choice A rationale:

Holding the drug and administering it 4 hours later is not the appropriate action. The trough vancomycin level of 24 mcg/mL is higher than the recommended range of 10-20 mcg/mL, indicating potential risk for toxicity. Administering the drug later does not address the immediate concern of a high trough level.

Choice B rationale:

Administering the vancomycin as ordered is not the correct action in this case. The trough level is above the recommended range, which could lead to vancomycin toxicity. The nurse should not administer the medication without addressing the high trough level. Choice C rationale:

This is the correct action. The nurse should hold the drug and notify the prescriber because the trough vancomycin level is higher than the recommended range. The prescriber can then make a decision based on this information, which may include adjusting the dose, extending the dosing interval, or ordering additional tests.

Choice D rationale:

While repeating the test to verify results might be done eventually, it should not be the immediate next step. The nurse has a responsibility to ensure patient safety, and with a trough level above the recommended range, the priority is to prevent potential toxicity. Therefore, the nurse should hold the drug and notify the prescriber.