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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

A) Tamsulosin is typically administered once daily, not on a twice-weekly dosing schedule. Instructing the client to adhere to the prescribed dosing frequency is essential for maintaining therapeutic blood levels of the medication and optimizing its effectiveness in managing urinary retention associated with benign prostatic hyperplasia (BPH).

B) While the timing of medication administration can impact its effectiveness, taking tamsulosin early in the day versus later in the day may not significantly affect its therapeutic action. The key consideration with tamsulosin is to maintain consistency in timing to ensure a steady plasma concentration of the drug.

C) Instructing the client to stand and sit up slowly is crucial because tamsulosin, as an alpha-blocker, can cause orthostatic hypotension, especially when first starting the medication or when increasing the dosage. By advising the client to change positions slowly, the nurse helps prevent falls and dizziness, which are common side effects associated with sudden drops in blood pressure.

D) Reducing daily fluid intake is not advisable, especially for a client with urinary retention. Maintaining adequate hydration is essential for overall health and urinary function. Tamsulosin works by relaxing the smooth muscles of the prostate and bladder neck, facilitating urine flow, but it does not directly affect fluid intake requirements.

Therefore, the most important instruction for the nurse to provide is to stand and sit up slowly to minimize the risk of orthostatic hypotension and associated complications.

A. Remove the patch and consult with the healthcare provider about the client’s pain resolution. B. Place the patch on the client’s shoulder and leave both patches in place for 12 hours. C. Apply the new patch in a different location after removing the original patch. D. Administer an oral analgesic and evaluate its effectiveness before applying the new patch.

Correct Answer is C

Explanation

A) Remove the patch and consult with the healthcare provider about the client’s pain resolution: While it’s essential to assess the need for continued pain management, removing the patch without replacing it could lead to inadequate pain control, especially if the client still requires opioid analgesia. Additionally, fentanyl patches are typically left in place for their prescribed duration, and removing them prematurely could disrupt the pain management plan.

B) Place the patch on the client's sh’ulder and leave both patches in place for 12 hours: Applying a new patch without removing the previous one could result in a higher-than-intended dose of fentanyl, increasing the risk of opioid toxicity. Leaving both patches in place simultaneously is not recommended.

C) Apply the new patch in a different location after removing the original patch: This is the correct action. Applying the new patch in a different location helps prevent skin irritation and ensures consistent drug absorption. Rotating patch sites according to the manufacturer's in’tructions is important for optimal medication delivery.

D) Administer an oral analgesic and evaluate its effectiveness before applying the new patch: While oral analgesics may provide temporary relief, they may not be as effective as transdermal fentanyl for managing chronic pain, especially if the client has been on a stable regimen of fentanyl patches. Additionally, delaying the application of the new patch could lead to inadequate pain control.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is receiving tamsulosin for the management of urinary retention due to benign prostatic hyperplasia (BPH), Which instruction is most important for the nurse to provide?

Correct Answer is C

Explanation

The nurse is preparing to apply the client’s scheduled fentanyl transdermal patch. The nurse notes the previously applied patch is intact on the client’s upper back and the client reports no pain. Which action should the nurse take?

Correct Answer is C

Explanation

A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. Which instruction should the nurse provide?

Six days after starting a prescription of an oral amoxicillin solution, a client calls the clinic to report the onset of a low grade fever. Which action should the nurse Implement?

Before administering the initial dose of sumatriptan succinate to a client with a migraine headache, it is most important to determine if the client's hi’tory includes which problem?

A young adult female client who is planning to become pregnant asks the nurse if she can continue taking isotretinoin for cystic acne. Which information is most important for the nurse to provide this client?