The nurse is reviewing the medication orders for a patient who will be receiving aminoglycoside therapy.
Which other medication or medication class, if ordered, would be a potential interaction concern?

Choice A rationale:

Sodium levels in the blood are typically between 135 and 145 milliequivalents per liter (mEq/L). A sodium level of 140 mEq/L falls within this range, indicating normal sodium levels. Sodium plays a key role in your body. It helps maintain normal blood pressure, supports the work of your nerves and muscles, and regulates your body’s fluid balance. A normal sodium level is therefore crucial for the body’s overall function.

Choice B rationale:

A glucose level of 120 mg/dL is considered normal for a fasting blood sugar test. Glucose is your body’s main source of energy. It comes from the food you eat and is carried through your bloodstream to the cells of your body. If the glucose level in the blood is too high or too low, it can indicate a medical condition such as diabetes.

Choice C rationale:

Potassium levels in the blood are typically between 3.6 and 5.2 millimoles per liter (mmol/L). A potassium level of 4.5 mEq/L falls within this range, indicating normal potassium levels. Potassium is a type of electrolyte that is vital to the function of nerve and muscle cells, including those in your heart. Your blood potassium level is normally 3.6 to 5.2 millimoles per liter (mmol/L). Having a blood potassium level higher than 6.0 mmol/L can be dangerous and usually requires immediate treatment.

Choice D rationale:

The Blood Urea Nitrogen (BUN) test is a routine test used to assess kidney function. Urea nitrogen is a waste product that’s created in your liver when the body breaks down proteins. Healthy kidneys filter urea nitrogen from your blood, but when your kidneys aren’t working well, the BUN level rises. The normal range for BUN is typically around 7-20 mg/dL2. A BUN level of 55 mg/dL is significantly higher than the normal range, indicating that the kidneys may not be functioning properly. This is a critical finding that should be reported to the provider before initiating the medication amphotericin B. Amphotericin B is an antifungal medication used to treat serious, life-threatening fungal infections. However, it is known for its severe and potentially lethal side effects, including kidney damage. Therefore, a high BUN level should be reported to the provider before initiating this medication.

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.