What is the best method of monitoring therapeutic blood levels of vancomycin during therapy?
By assessing the temperature every 4 hours
By repeating a culture and sensitivity test on day 3
By obtaining drug peak and trough levels
By assessing for breathlessness
The Correct Answer is C
A. By assessing the temperature every 4 hours:
Monitoring temperature every 4 hours is a common practice in hospitalized patients to detect fever, which could indicate an infection or an inflammatory response. However, this method does not directly assess the therapeutic blood levels of vancomycin. Fever alone does not provide specific information about the effectiveness or concentration of the antibiotic in the bloodstream.
B. By repeating a culture and sensitivity test on day 3:
Culture and sensitivity tests involve taking a sample from the patient (such as blood, urine, or sputum) and growing the microorganisms in a laboratory to identify the causative organism and determine its susceptibility to antibiotics. While this test is essential for identifying the appropriate antibiotic therapy initially, repeating it on day 3 does not directly monitor therapeutic blood levels of vancomycin. It also doesn't provide real-time information about the concentration of vancomycin in the bloodstream.
C. By obtaining drug peak and trough levels:
This choice involves measuring the highest (peak) and lowest (trough) concentrations of vancomycin in the bloodstream. Peak levels are typically measured about 1 hour after the completion of a vancomycin infusion, while trough levels are measured just before the next dose is administered. These measurements allow healthcare providers to ensure that the drug concentration remains within the therapeutic range to effectively treat the infection while minimizing the risk of toxicity.
D. By assessing for breathlessness:
Assessing for breathlessness is important for monitoring respiratory status, particularly in patients receiving vancomycin, as rare side effects like red-man syndrome or anaphylaxis can cause respiratory distress. However, this method does not directly monitor therapeutic blood levels of vancomycin.
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Related Questions
Correct Answer is B
Explanation
A. “It’s fine for me to become pregnant while taking this medication.”
This statement is incorrect. Tetracycline is known to have teratogenic effects, meaning it can harm the developing fetus if taken during pregnancy. Women of childbearing age should use effective contraception while taking tetracycline and avoid becoming pregnant during treatment.
B. “I will need to postpone my vacation at the beach until I finish this medication."
This statement demonstrates an understanding of the discharge instructions. Tetracycline can increase the risk of sunburn and photosensitivity reactions. Therefore, it's advisable for the client to avoid prolonged sun exposure, particularly during peak sunlight hours, and to use sun protection measures such as wearing protective clothing, using sunscreen, and avoiding tanning beds or sunlamps. Postponing a vacation at the beach until after finishing the medication is a prudent precaution to minimize the risk of sun-related side effects.
C. “I am so glad to be leaving today because I have an appointment at the tanning salon."
This statement is incorrect. Tetracycline can increase the risk of sunburn and photosensitivity reactions. Visiting a tanning salon while taking tetracycline can further increase the risk of skin damage and should be avoided.
D. "I will stop taking this medication as soon as I feel better.”
This statement is incorrect. It's important for the client to complete the full course of tetracycline as prescribed by their healthcare provider, even if they start to feel better before finishing the medication. Stopping the medication prematurely can lead to incomplete treatment and potential recurrence of the infection.
Correct Answer is D
Explanation
A. Food, Drug and Cosmetic Act:
The Food, Drug, and Cosmetic Act (FD&C Act) is a federal law that regulates the manufacturing, labeling, and distribution of food, drugs, cosmetics, and medical devices in the United States. While the FD&C Act does provide some regulatory authority over certain aspects of dietary supplements, such as labeling requirements and good manufacturing practices, it is not the primary law governing the regulation of herbal and dietary supplements.
B. Joint Commission on the Accreditation of Healthcare Organizations:
The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), now known as The Joint Commission, is an independent, nonprofit organization that accredits and certifies healthcare organizations and programs in the United States. However, The Joint Commission is not responsible for regulating herbal and dietary supplements.
C. Health and Human Services (HHS):
The Department of Health and Human Services (HHS) is a cabinet-level executive branch department of the U.S. federal government. While HHS oversees various health-related agencies, including the Food and Drug Administration (FDA), it is not the primary regulatory authority for herbal and dietary supplements.
D. Dietary Supplement Health and Education Act (DSHEA):
The Dietary Supplement Health and Education Act (DSHEA) of 1994 is the primary law that regulates herbal and dietary supplements in the United States. DSHEA defines dietary supplements, sets forth labeling requirements, establishes good manufacturing practices, and outlines the responsibilities of manufacturers and distributors of dietary supplements. Under DSHEA, dietary supplements are regulated as a category of food rather than as drugs.
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