A nurse is preparing to administer flucytosine to a client who has a systemic fungal infection.
Which of the following assessments should the nurse perform before giving this medication? (Select all that apply.).

Flucytosine can cause bone marrow suppression and renal toxicity, so the nurse should monitor the client’s renal function tests and complete blood count before giving this medication.

These tests can help detect any signs of anemia, leukopenia, thrombocytopenia, or impaired kidney function that may require dose adjustment or discontinuation of the drug.

Choice A is wrong because flucytosine does not affect liver function significantly.Choice C is wrong because flucytosine does not cause changes in blood pressure.Choice E is wrong because flucytosine does not affect cardiac function or cause arrhythmias.

These are signs ofototoxicity, a potentially serious adverse reaction to vancomycin (Vancocin) and other aminoglycosides.Ototoxicity can damage the inner ear and cause permanent hearing loss or balance problems.

Choice A is wrong because redness and itching at the infusion site are not specific to vancomycin (Vancocin) and could indicate a local irritation or an allergic reaction to any drug.

Choice B is wrong because flushing, rash, and pruritus on the face and upper torso are symptoms ofred man syndrome, a common but not serious side effect of vancomycin (Vancocin) that occurs due to rapid infusion and histamine release.Red man syndrome can be prevented by infusing the drug over at least 1 hour.

Choice C is wrong because nausea, vomiting, and abdominal cramps are not specific to vancomycin (Vancocin) and could be caused by many factors, such as infection, food poisoning, or other drugs.

Normal ranges for vancomycin (Vancocin) trough levels are 10 to 20 mcg/mL for most infections and 15 to 20 mcg/mL for serious infections such as osteomyelitis, endocarditis, or meningitis.Levels above 20 mcg/mL increase the risk of ototoxicity and nephrotoxicity.

Therefore, the nurse should monitor the patient’s trough levels regularly and report any abnormal findings to the prescriber.