The nurse is scheduled to administer the patient’s next dose of vancomycin at 9:30 a.m. At what time should the nurse draw the patient’s blood to check the trough vancomycin level?

Choice A rationale:

Echinacea: It has anti-inflammatory properties and is not typically associated with exacerbating rheumatoid arthritis symptoms. Studies have shown potential benefits in reducing inflammation, including evidence of possible effectiveness for osteoarthritis and rheumatoid arthritis. However, more research is needed to confirm its efficacy and safety in rheumatoid arthritis.

Choice B rationale:

Turmeric:

Curcumin, the active component of turmeric, has both anti-inflammatory and pro-inflammatory effects.

While it has potential benefits for some inflammatory conditions, it can also stimulate the immune system, which could worsen rheumatoid arthritis symptoms in certain individuals.

Studies have shown mixed results, with some indicating potential benefits and others suggesting a possible worsening of symptoms.

Due to this uncertainty, caution is advised, and patients with rheumatoid arthritis should consult with their healthcare providers before using turmeric supplements.

Choice C rationale:

Ginger: It has well-documented anti-inflammatory properties and is not known to exacerbate rheumatoid arthritis symptoms.

Studies have shown ginger to be potentially effective in reducing pain and inflammation in individuals with rheumatoid arthritis.

It is generally considered safe for use in this population.

Choice D rationale:

Valerian: It is a herb primarily used for its sedative and sleep-promoting effects.

It has not been shown to have any significant impact on inflammation or rheumatoid arthritis symptoms. There is no evidence to suggest that it would worsen the condition.

Choice A rationale:

Stage 1 pressure injury:

Non-blanchable erythema of intact skin: This means that when you press on the area, the redness does not disappear. It is persistent and remains even after pressure is relieved, unlike other types of skin redness that may blanch temporarily.

Intact skin: This is a crucial characteristic of Stage 1. The skin is not broken or open, differentiating it from more advanced stages.

Commonly over bony prominences: The malleolus, or ankle bone, is a bony prominence that is susceptible to pressure injuries due to its location and potential for prolonged pressure.

Explanation:

Non-blanchable erythema: The description of the redness as "non-blanchable" is the key indicator of a Stage 1 pressure injury. Blanchable erythema, which disappears when pressure is applied, can be due to other causes like inflammation or skin irritation, but non-blanchable erythema signals a deeper issue with the tissue.

Intact skin: The fact that the skin is intact rules out Stages 2, 3, and 4, which all involve some degree of skin breakdown.

Location on a bony prominence: The malleolus is a common site for pressure injuries because it's a bony area that often bears weight, especially in those with limited mobility or those confined to beds or chairs.

Additional Information:

Pressure injuries, also known as pressure ulcers or bed sores, are areas of damage to the skin and underlying tissue caused by prolonged pressure.

They are a common problem in healthcare settings, particularly among patients with limited mobility. Early identification and intervention are crucial to prevent progression to more severe stages.