The client is a 75-year-old female admitted to the preoperative area to prepare for pacemaker insertion. Client reports she is having this done because her heart rate has been staying very low, she is always tired, and she has passed out once from low heart rate. Client has history of worsening symptomatic bradycardia. History of atrial fibrillation controlled. The nurse is preparing the client's plan of care. Select 4 findings that would indicate to the nurse that the administration of the vancomycin antibiotic would be safe to administer.
No known allergies
Peripheral IV in large vein
Potassium 4.4 mEq/L (4.4 mmol/L)
Used for prophylaxis
Blood urea nitrogen 17 mg/dL (6.07 mmol/L)
Dosage in safe range
Correct Answer : A,B,D,F
A. No known allergies:
Having no known allergies is a significant factor in determining the safety of administering vancomycin, as it reduces the risk of an allergic reaction. Vancomycin can cause allergic reactions or hypersensitivity, so it’s important to ensure the client is not allergic to this medication.
B. Peripheral IV in large vein:
Vancomycin should be administered through a large vein because it can be irritating to smaller veins and potentially cause thrombophlebitis or vein damage. Using a large vein helps to minimize these risks and ensure safe administration.
C. Potassium 4.4 mEq/L (4.4 mmol/L):
While potassium levels are important to monitor, they are not directly related to the safety of administering vancomycin. Vancomycin does not have a direct impact on potassium levels, so this finding does not specifically indicate the safety of vancomycin administration.
D. Used for prophylaxis:
Vancomycin is often used as prophylaxis in certain surgical procedures to prevent infection, especially in cases where there is a high risk of methicillin-resistant Staphylococcus aureus (MRSA) infection. The use of vancomycin for prophylaxis is a common practice and indicates it is being administered for an appropriate reason.
E. Blood urea nitrogen 17 mg/dL (6.07 mmol/L):
A blood urea nitrogen (BUN) level of 17 mg/dL is slightly elevated but not necessarily a contraindication for vancomycin administration. However, vancomycin can impact kidney function, so it is important to monitor renal function but not the sole factor in determining safety.
F. Dosage in safe range:
Ensuring the dosage of vancomycin is within the safe range is crucial for preventing toxicity and achieving therapeutic efficacy. This is an essential consideration when administering the medication to avoid adverse effects and ensure effective treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Double the dose if a dose is missed:
This instruction is incorrect. Clients should not double their dose of allopurinol if they miss a dose. Instead, they should take the missed dose as soon as they remember, unless it is almost time for the next dose. Doubling the dose can lead to overdose and potential side effects.
B. Reduce caffeine and acidic intake:
Reducing caffeine and acidic foods can help manage gout and lower uric acid levels, making this advice appropriate.
C. Avoid taking on an empty stomach:
While allopurinol can be taken with or without food, some clients might find it less irritating if taken with food. This guidance is intended to reduce gastrointestinal discomfort.
D. Consume 2 liters of water daily:
Drinking adequate fluids helps prevent kidney stones and promotes overall kidney health, which is especially important when taking allopurinol. This advice supports effective medication use and overall health.
Correct Answer is C
Explanation
A) Use the cream only on intact skin: This is correct advice as applying betamethasone cream to broken or infected skin can exacerbate the condition or lead to systemic absorption and side effects. Ensuring the cream is applied only to intact skin helps prevent complications.
B) Apply the cream to the area for 2 weeks: This instruction is appropriate depending on the severity of the eczema and the prescribing healthcare provider’s guidance. Typically, topical corticosteroids like betamethasone are used for a prescribed duration, often not exceeding 2 weeks to avoid potential side effects.
C) Cover the site with an occlusive dressing: This indicates a need for further teaching. Occlusive dressings are generally not recommended with topical corticosteroids unless specifically instructed by a healthcare provider. They can increase the absorption of the medication, potentially leading to more side effects, such as thinning of the skin.
D) Limit exposure to direct sunlight: This is good advice because corticosteroids can increase skin sensitivity to sunlight, leading to potential sunburn or other skin issues. Clients should be advised to protect their skin from excessive sun exposure while using such medications.
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