The nurse is providing instructions about a client's new medications. How should the nurse explain the purpose of probenecid, a uricosuric drug?

choice A, drawing blood two hours after the IV dose completion would miss the peak serum level of vancomycin, which typically occurs shortly after the dose is administered. This timing would not accurately reflect the highest concentration of the drug in the bloodstream.

Choice B, while closer to the peak, still may not capture the maximum serum level as the peak can occur within 30 minutes to 1 hour after administration.

Choice C is incorrect because drawing blood 30 minutes into the IV dose would not allow the full dose to circulate and reach peak levels in the bloodstream.

Choice D is the most appropriate because drawing blood immediately after the IV dose completion captures the peak concentration, and drawing 30 minutes before the next dose captures the trough level, or the lowest concentration, right before the subsequent dose is given, providing a complete profile of the drug's serum levels.

Choice A rationale: This instruction is not directly related to spironolactone use or hyperaldosteronism. Excessive bruising may be relevant in some situations but not specifically for this scenario.
Choice B rationale: While heart failure patients are often advised to reduce their sodium intake, the use of a salt substitute (potassium-based) would be contraindicated in this case due to the risk of hyperkalemia.
Choice C rationale: This instruction is not directly related to spironolactone use or
hyperaldosteronism. It may be relevant for sun protection, but it is not a priority in this context.
Choice D rationale: Spironolactone is a potassium-sparing diuretic, which means it helps the body retain potassium while excreting sodium and water. Since the client has heart failure (HF), there is a risk of hyperkalemia (high potassium levels) associated with spironolactone use. To prevent this, the nurse should instruct the client to limit their intake of high-potassium foods, such as bananas, oranges, tomatoes, spinach, and other potassium-rich foods.