A patient has a urinary tract infection.
The nurse knows that which class of drugs is especially useful for such infections?

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.

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.