The nurse is administering a vancomycin infusion.

What measure should the nurse implement to reduce complications that may occur with this drug’s administration?

Monitor blood pressure for hypertension during the infusion.

Restrict fluids during vancomycin therapy.

Infuse the drug over at least 1 hour.

Discontinue the drug immediately if red man syndrome occurs.

Answer and Explanation

The Correct Answer is C

Choice A rationale
Monitoring blood pressure for hypertension during the infusion is important, but it is not the primary measure to reduce complications with vancomycin administration3.
Choice B rationale
Restricting fluids during vancomycin therapy is not recommended. Adequate hydration is important when receiving vancomycin to prevent kidney damage3.
Choice C rationale
Infusing the drug over at least 1 hour is the most crucial measure to reduce complications that may occur with vancomycin administration. This is to prevent “red man syndrome,” a reaction that can cause flushing, rash, and hypotension3.
Choice D rationale
Discontinuing the drug immediately if red man syndrome occurs is not the primary measure. The infusion can often be slowed down or temporarily stopped to manage this reaction3.

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Correct Answer is C

Explanation

Step 1 is: The client’s finger stick blood glucose is 128, which is within the normal range, so no additional insulin is needed for blood sugar correction. The client has 4 units of insulin lispro scheduled with meals. Therefore, the nurse will administer the scheduled 4 units of insulin.

A. The corticosteroids may have caused an increase in glucose levels. B. The type 2 diabetes has now converted to type 1. C. The bronchitis has made the tissues less sensitive to insulin. D. The antibiotics may have caused an increase in glucose levels.

Correct Answer is A

Explanation

Choice A rationale
Corticosteroids, like the ones the client has been receiving for severe bronchitis, can cause an increase in glucose levels. This is because corticosteroids can stimulate the liver to release extra glucose and can also make body tissues less sensitive to insulin.
Choice B rationale
Type 2 diabetes does not convert to type 1 diabetes. These are two distinct conditions with different causes.
Choice C rationale
While illness and stress can make the body’s tissues less sensitive to insulin, leading to higher blood glucose levels, the client’s bronchitis symptoms have resolved. Therefore, this is not the most likely reason for the increase in glucose levels.
Choice D rationale
Antibiotics do not typically cause an increase in glucose levels. Therefore, this is not the most likely reason for the increase in glucose levels.

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The nurse is administering a vancomycin infusion. What measure should the nurse implement to reduce complications that may occur with this drug’s administration?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is to administer insulin to a diabetic client. The finger stick blood glucose is 128. The client has 4 units of insulin lispro scheduled with meals in addition to the following adjustments scale. How many units of insulin will the nurse administer?

Correct Answer is C

Explanation

Correct Answer is A

Explanation

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The nurse is administering a vancomycin infusion.

What measure should the nurse implement to reduce complications that may occur with this drug’s administration?