Before administering an antibiotic that can cause nephrotoxicity, which laboratory value is most important for the practical nurse (PN) to review?

Serum calcium

Serum creatinine

Hemoglobin and Hematocrit

White blood cell count (WBC)

Answer and Explanation

The Correct Answer is B

Serum creatinine is the most important laboratory value to review before administering an antibiotic that can cause nephrotoxicity. Nephrotoxicity is an alteration in the function of the kidney due to exposure to certain drugs or toxins.

It can be assessed by measuring the glomerular filtration rate (GFR), which is the rate of clearance of a substance from the blood by the kidneys. Serum creatinine is a waste product of muscle metabolism that is freely filtered by the glomeruli and not reabsorbed or secreted by the tubules.

Therefore, it is a reliable indicator of GFR and renal function. An increase in serum creatinine indicates a decrease in GFR and renal function, which may be caused by nephrotoxic drugs.

The other laboratory values are not directly related to nephrotoxicity or GFR:

Serum calcium: This may be aﬀected by renal function, but it is not a sensitive or specific marker of nephrotoxicity. It may be altered by other factors such as vitamin D, parathyroid hormone, and bone metabolism.
Hemoglobin and hematocrit: These may be aﬀected by renal function, but they are not sensitive or specific markers of nephrotoxicity. They may reﬂect the erythropoietin production by the kidneys, which stimulates red blood cell production in the bone marrow. However, they may also be inﬂuenced by other factors such as blood loss, hydration status, and iron deficiency.
White blood cell count (WBC): This is not related to nephrotoxicity or GFR. It may reﬂect the presence of infection or inﬂammation, which may be a cause or a consequence of renal impairment, but it is not a direct measure of renal function.

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Correct Answer is D

Explanation

Choice A rationale:

Tetracycline antibiotics can form insoluble complexes with calcium, reducing their absorption when taken together. Therefore, advising the client to continue taking calcium supplements with food while on tetracycline therapy is not recommended as it may decrease the effectiveness of the antibiotic.

Choice B rationale:

The nurse should advise the client to avoid taking calcium supplements while on tetracycline therapy. Calcium-containing products (such as supplements, dairy products, and antacids) should be taken at least 2 hours before or after tetracycline administration to minimize the interference with drug absorption.

Choice C rationale:

Taking calcium supplements with tetracycline, even with plenty of water, can still lead to reduced drug absorption due to the formation of insoluble complexes. Therefore, this advice is not appropriate.

Choice D rationale:

The nurse should recommend that the client take calcium supplements at least 2 hours before or after tetracycline. This approach ensures that the client receives the full therapeutic benefit of the antibiotic while still meeting their calcium needs separately.

Correct Answer is ["1"]

Explanation

This is the correct answer because the concentration of cefazolin after reconstitution is 1 gram/2.5 mL, which is equivalent to 400 mg/1 mL. Therefore, to administer 400 mg of cefazolin, the PN should draw up 1 mL of the reconstituted solution. This can be calculated using the formula:

Desired dose / Available dose = Volume to administer

400 mg / 1000 mg = x mL / 2.5 mL

x = (400 x 2.5) / 1000

x = 1 mL

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Before administering an antibiotic that can cause nephrotoxicity, which laboratory value is most important for the practical nurse (PN) to review?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

Correct Answer is ["1"]

Explanation

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