A peak and trough level was obtained from a client receiving an aminoglycoside IV every 8 hours. Which finding presents the highest risk for the client and should be reported immediately to the healthcare provider?
Decreased peak, decreased trough.
Decreased trough only.
Increased peak, increased trough.
Decreased peak only.
The Correct Answer is C
A) A decreased peak and trough level may indicate subtherapeutic levels of the medication but do not pose an immediate risk to the client. Adjustments to the dosing regimen may be needed, but this finding does not require immediate action.
B) A decreased trough level alone may suggest a need for dosage adjustment but does not present an immediate risk to the client. It is important to monitor therapeutic drug levels, but this finding does not require immediate reporting to the healthcare provider.
C) An increased peak and trough level indicates potential toxicity of the medication. Increased peak levels can lead to nephrotoxicity, while increased trough levels can lead to ototoxicity. Both conditions are serious and require immediate action to prevent harm to the client. The nurse should report this finding immediately to the healthcare provider for further evaluation and possible adjustment of the medication regimen.
D) A decreased peak level alone may indicate subtherapeutic levels of the medication, but it does not pose an immediate risk to the client. Adjustments to the dosing regimen may be needed, but this finding does not require immediate action.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["133"]
Explanation
The nurse should program the infusion pump to deliver approximately 133 ml/hour.
Here's how we can calculate the rate:
Total volume of infusion (mL): 200 mL (dextrose 5% in water)
Infusion time (minutes): 90 minutes
We need to convert the infusion time to hours for the pump rate calculation:
Infusion time (hours) = 90 minutes / 60 minutes/hour
Infusion time (hours) = 1.5 hours
Now, calculate the flow rate (mL/hr):
Flow rate (mL/hr) = Total volume (mL) / Infusion time (hours)
Flow rate (mL/hr) = 200 mL / 1.5 hours
Flow rate (mL/hr) = 133.33 mL/hr (round to nearest whole number as requested)
Therefore, the nurse should program the pump to deliver 133 ml/hour.
Correct Answer is D
Explanation
A) Breastfeeding is not recommended while taking this medication: While it’s important for clients to avoid breastfeeding while taking isotretinoin due to potential harm to the infant, the primary concern for a young adult female planning to become pregnant is the risk of teratogenic effects on the fetus. Therefore, while this information is relevant, it’s not the most important consideration in this situation.
B) Do not take multiple vitamins that contain vitamin A while taking this drug: Avoiding excessive intake of vitamin A is essential to prevent toxicity, but it’s not the most critical consideration for a client planning to become pregnant. The main concern is the teratogenic effects of isotretinoin on the fetus.
C) Baseline liver function results must be obtained during therapy: Monitoring liver function is important during isotretinoin therapy to assess for potential hepatotoxicity, but it’s not the most crucial consideration for a client planning to become pregnant. The primary concern is the need to discontinue the medication before conception to prevent fetal exposure.
D) Discontinue this medication one month before attempting to conceive: This is the most important information for the nurse to provide to the client. Isotretinoin is highly teratogenic and can cause severe birth defects if taken during pregnancy. Therefore, it’s essential for the client to discontinue isotretinoin at least one month before attempting to conceive to ensure the drug is cleared from the body and to prevent fetal exposure.
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