Examine the following patient data for a patient who has been prescribed vancomycin.
The nurse is evaluating a patient after administering several doses of Vancomycin IV. Which of the following changes would indicate a therapeutic response to the medication? (Select all that apply)

WBC count of 16,000/mm

BUN level of 42 mg/dl

Blood pressure reading of 95/64

Body temperature of 101.8F

Answer and Explanation

Correct Answer : A,C,D

Choice A rationale:

A WBC count of 16,000/mm is higher than the normal range of 5,000 to 10,000 cells/mm. This indicates that the body is fighting an infection, which is a common reason for prescribing Vancomycin. Therefore, a high WBC count could indicate a therapeutic response to the medication as it suggests that the body’s immune system is actively fighting the infection.

Choice B rationale:

A BUN level of 42 mg/dl is higher than the normal range of 7 to 20 mg/dL3456. Elevated BUN levels can indicate kidney damage or disease, which is not a desired therapeutic response to Vancomycin. Vancomycin can be nephrotoxic, and its use requires careful monitoring of kidney function. Therefore, a high BUN level does not indicate a therapeutic response to the medication. Choice C rationale:

A blood pressure reading of 95/64 is considered normal. Maintaining normal blood pressure is important for overall health and can indicate that the patient’s body is responding well to the medication. Therefore, a blood pressure reading within the normal range could indicate a therapeutic response to Vancomycin.

Choice D rationale:

A body temperature of 101.8F is considered a fever14. Fever is a common response to infection and can indicate that the body is fighting off an infection, which is a common reason for prescribing Vancomycin. Therefore, a high body temperature could indicate a therapeutic response to the medication as it suggests that the body’s immune system is actively fighting the infection.

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Correct Answer is D

Explanation

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.

A. “I will feel shaky.” B. “My skin will be warm and moist.” C. “I will be more thirsty than usual.” D. “My appetite will be decreased.”

Correct Answer is A

Explanation

Choice A rationale:

Hypoglycemia, also known as low blood sugar, is a condition where blood sugar levels fall below the standard range. It is often related to diabetes treatment. When blood glucose levels are too low, individuals may experience symptoms such as shakiness, which is why the statement “I will feel shaky” indicates an understanding of the manifestations of hypoglycemia.

Choice B rationale:

The statement “My skin will be warm and moist” does not accurately represent the symptoms of hypoglycemia. While sweating can be a symptom of hypoglycemia, it does not necessarily mean that the skin will feel warm and moist. Therefore, this choice does not indicate a correct understanding of the manifestations of hypoglycemia.

Choice C rationale:

The statement “I will be more thirsty than usual” is more commonly associated with hyperglycemia, or high blood sugar, rather than hypoglycemia. Thirst is not typically a symptom of low blood sugar. Therefore, this choice does not indicate a correct understanding of the manifestations of hypoglycemia.

Choice D rationale:

The statement “My appetite will be decreased” is not a typical symptom of hypoglycemia. In fact, hunger is a common symptom of low blood sugar. Therefore, this choice does not indicate a correct understanding of the manifestations of hypoglycemia.

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Examine the following patient data for a patient who has been prescribed vancomycin. The nurse is evaluating a patient after administering several doses of Vancomycin IV. Which of the following changes would indicate a therapeutic response to the medication? (Select all that apply)

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Correct Answer is D

Explanation

A nurse is reinforcing teaching with a client who has diabetes mellitus about the manifestations of hypoglycemia. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is A

Explanation

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Examine the following patient data for a patient who has been prescribed vancomycin.
The nurse is evaluating a patient after administering several doses of Vancomycin IV. Which of the following changes would indicate a therapeutic response to the medication? (Select all that apply)