The nurse checks the patient’s laboratory work prior to administering a dose of vancomycin and finds that the trough vancomycin level is 24 mcg/mL. What will the nurse do next?
Hold the drug, and administer 4 hours later.
Administer the vancomycin as ordered.
Hold the drug, and notify the prescriber.
Repeat the test to verify results.
The Correct Answer is C
Choice A rationale:
Holding the drug and administering it 4 hours later is not the appropriate action. The trough vancomycin level of 24 mcg/mL is higher than the recommended range of 10-20 mcg/mL, indicating potential risk for toxicity. Administering the drug later does not address the immediate concern of a high trough level.
Choice B rationale:
Administering the vancomycin as ordered is not the correct action in this case. The trough level is above the recommended range, which could lead to vancomycin toxicity. The nurse should not administer the medication without addressing the high trough level. Choice C rationale:
This is the correct action. The nurse should hold the drug and notify the prescriber because the trough vancomycin level is higher than the recommended range. The prescriber can then make a decision based on this information, which may include adjusting the dose, extending the dosing interval, or ordering additional tests.
Choice D rationale:
While repeating the test to verify results might be done eventually, it should not be the immediate next step. The nurse has a responsibility to ensure patient safety, and with a trough level above the recommended range, the priority is to prevent potential toxicity. Therefore, the nurse should hold the drug and notify the prescriber.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Acyclovir is an antiviral medication used to treat infections caused by certain types of viruses. It is primarily used for the treatment of herpes simplex virus infections, chickenpox, and shingles. However, it is not typically used as an anti-HIV drug.
Choice B rationale:
Ribavirin is an antiviral medication used to treat hepatitis C and certain other viral infections. While it has broad-spectrum antiviral activity, it is not specifically used to prevent mother-to-child transmission of HIV.
Choice C rationale:
Foscarnet is an antiviral medication used to treat or prevent cytomegalovirus (CMV) retinitis in individuals with AIDS. It is also used to treat cold sores and genital herpes. However, it is not the first-line choice for preventing mother-to-child transmission of HIV.
Choice D rationale:
Zidovudine, also known as AZT, is an antiretroviral medication used to prevent and treat HIV/AIDS. It is generally safe for use during pregnancy and is commonly used to prevent mother-to-child transmission of HIV12. It works by inhibiting the reverse transcriptase enzyme, thereby blocking viral replication. The use of Zidovudine and other antiretroviral drugs in pregnant women with HIV has significantly reduced the rate of mother-to-child transmission of the virus.
Correct Answer is C
Explanation
Choice A rationale:
Proton pump inhibitors (PPIs) are used extensively for the treatment of gastric acid-related disorders, often over the long term, which raises the potential for clinically significant drug interactions in patients receiving concomitant medications.
However, there is no specific mention of a significant interaction between PPIs and aminoglycosides.
Choice B rationale:
Aminoglycoside antibiotics and calcium channel blockers can interact at the neuromuscular junctions. This interaction is of clinical significance because when these agents are given concurrently during the perioperative period they may lead to respiratory depression or prolonged apnea. However, this is not directly related to the therapeutic effect of aminoglycosides, but rather a side effect of their combined use.
Choice C rationale:
The loop-diuretics (ethacrynic acid, furosemide, bumetamide) and aminoglycoside antibiotics (kanamycin, gentamicin, tobramycin, amikacin, etc.) are important drugs frequently used to treat seriously ill patients. Not uncommonly both types of drugs are given to the same patient exposing that patient to the risk of a hearing loss (ototoxicity)5. In addition, the risk of ototoxicity could be enhanced by the concomitant use of loop diuretics and aminoglycoside antibiotics.
Choice D rationale:
Phenytoin is a medication used to treat seizures. It has a complex pharmacokinetic profile and can interact with many other drugs. However, there is no specific mention of a significant interaction between phenytoin and aminoglycosides.
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