A nurse is planning to administer vancomycin IV to a client. Which of the following actions should the nurse take to reduce the risk of an adverse reaction to the vancomycin?

Give the dose over 60 min.

Administer the medication undiluted.

Inject 19% lidocaine prior to each dose.

Obtain a trough level 30 min after the medication infusion.

Answer and Explanation

The Correct Answer is A

A.   Administering vancomycin over a longer infusion time, such as 60 minutes, can help reduce the risk of adverse reactions, such as red man syndrome or nephrotoxicity. Slower infusion rates allow for better tolerance of the medication.
B.   Vancomycin should be diluted appropriately before administration to reduce the risk of infusion-related reactions.
C.   Lidocaine is not typically used prior to vancomycin administration. The use of lidocaine would be more relevant for local anesthesia, not for systemic medication administration like vancomycin.

D.   Trough levels are typically obtained just before the next dose of vancomycin is due, not immediately after the infusion.

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Correct Answer is D

Explanation

A. This would involve irregular beats and potentially a visible compensatory pause, not a prolonged PR interval.
B. Atrial fibrillation features an irregularly irregular rhythm and no discernible PR intervals.

C. Defined by a heart rate less than 60/min with a normal rhythm and electrical pattern, which does not apply here given the normal rate and prolonged PR interval.
D. A first-degree atrioventricular (AV) block is characterized by a prolonged PR interval (greater than 0.20 seconds) in the presence of a normal heart rate and rhythm, which aligns with the client’s PR interval of 0.24 seconds and a heart rate of 69/min

A. Administer sedation for the procedure. B. Schedule an MRI postprocedure to verify placement. C. Use gauze to secure an arm board to the involved extremity. D. Measure the arm circumference above the insertion site daily

Correct Answer is D

Explanation

A: Sedation is not typically required for PICC line insertion; local anesthesia is usually sufficient.
B: An MRI is not the standard method to verify PICC line placement; an x-ray is typically used.
C: Using gauze to secure an arm board can restrict circulation and is not recommended for securing a PICC line.
D: Measuring the arm circumference daily is important to monitor for complications such as swelling or phlebitis at the insertion site.

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A nurse is planning to administer vancomycin IV to a client. Which of the following actions should the nurse take to reduce the risk of an adverse reaction to the vancomycin?

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