A patient has been admitted with a fever of 102.8 F (39.3 C), with an unknown origin.
The patient’s urine is cloudy, foul-smelling, and dark amber.
Orders have been given to obtain urine and blood cultures immediately and to administer an antibiotic intravenously.
In what order should the nurse complete these orders?
Administer the antibiotic dose, then obtain blood and urine cultures.
Obtain urine culture, administer the antibiotic dose, then obtain blood culture.
Obtain blood culture, administer the antibiotic dose, then obtain urine culture.
Obtain blood and urine cultures, then administer the antibiotic dose.
The Correct Answer is D
Choice A rationale:
Administering the antibiotic dose before obtaining the cultures could potentially affect the results of the cultures. Antibiotics are designed to kill or inhibit the growth of bacteria, so administering them before obtaining the cultures could lead to false negatives. This could lead to incorrect or delayed diagnosis and treatment.
Choice B rationale:
While obtaining the urine culture before administering the antibiotic dose is a good step, it should not be done before obtaining the blood culture. Blood cultures are usually obtained before urine cultures because they can help identify bacteria or fungi in the blood. This can be crucial in diagnosing conditions like sepsis. Furthermore, administering the antibiotic dose before obtaining the blood culture could affect the results of the culture.
Choice C rationale:
Obtaining the blood culture before administering the antibiotic dose is a good step, but the urine culture should also be obtained before the antibiotic dose is administered. Administering the antibiotic dose before obtaining all necessary cultures could affect the results of the cultures and lead to incorrect or delayed diagnosis and treatment.
Choice D rationale:
This is the correct sequence of actions. The nurse should first obtain both blood and urine cultures before administering the antibiotic dose. This is because the antibiotic could potentially kill or inhibit the growth of bacteria, which could affect the results of the cultures. By obtaining the cultures first, the healthcare team can ensure they are getting accurate results that have not been influenced by the antibiotics. This can lead to a more accurate diagnosis and more effective treatment plan.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
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.
Correct Answer is ["B","C","D"]
Explanation
Choice A rationale:
Polyuria, which is frequent or excessive urination, is not typically a symptom of hypoglycemia. It is more commonly associated with hyperglycemia, or high blood sugar levels.
Choice B rationale:
Sweating is indeed a common symptom of hypoglycemia. When blood sugar levels fall too low, the body may respond by sweating as it releases adrenaline in response to the hypoglycemic state.
Choice C rationale:
Tachycardia, or a fast heartbeat, is another common symptom of hypoglycemia. This is part of the body’s response to low blood sugar levels, as it releases adrenaline to try to raise these levels.
Choice D rationale:
Blurry vision can be a symptom of hypoglycemia. When blood sugar levels fall, it can affect the ability of the eyes to focus, leading to blurry vision.
Choice E rationale:
Polydipsia, or excessive thirst, is not typically a symptom of hypoglycemia. Like polyuria, it is more commonly associated with hyperglycemia.
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