When a patient is undergoing aminoglycoside therapy, which indicators should the nurse monitor for potential toxicity?

Decreased blood urea nitrogen (BUN) levels

Fever

White blood cell count of 5000 cells/mm

Tinnitus and dizziness

Answer and Explanation

The Correct Answer is D

Choice A rationale:

Aspirin is known as a salicylate and a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking a certain natural substance in your body to reduce pain and swelling. However, one of the key reasons aspirin is administered to a patient with a history of myocardial infarction (MI) is due to its antiplatelet aggregate properties. This effect reduces the risk of stroke and heart attack. If a patient has recently had surgery on clogged arteries (such as bypass surgery, carotid endarterectomy, coronary stent), doctors may direct them to use aspirin in low doses as a “blood thinner” to prevent blood clots.

Choice B rationale:

While aspirin does have analgesic properties, meaning it can relieve mild to moderate pain from conditions such as muscle aches, toothaches, common cold, and headaches, this is not the primary reason it would be administered to a patient with a history of MI. The main goal in this context is to prevent further cardiac events, which is achieved through aspirin’s antiplatelet effects.

Choice C rationale:

Aspirin does have anti-inflammatory properties and it may be used to reduce pain and swelling in conditions such as arthritis. However, in the context of a patient with a history of MI, the anti-inflammatory property is not the primary reason for administering aspirin. The key purpose is to leverage its antiplatelet effects to prevent further cardiac events.

Choice D rationale:

Aspirin can be used to reduce fever, which is what the term ‘antipyretic’ refers to. However, similar to the analgesic and antiinflammatory properties, the antipyretic property is not the primary reason for administering aspirin to a patient with a history of MI. The main goal is to prevent further cardiac events through its antiplatelet effects.

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Correct Answer is ["2 tablets."]

Explanation

Let’s solve the medication math problem step by step:

Step 1: Identify the total daily dose of amoxicillin. The total daily dose is 2 gm/day.

Step 2: Convert the total daily dose from grams to milligrams, as the available medication is in milligrams. We know that 1 gm = 1000 mg, so 2 gm = 2000 mg.

Step 3: The total daily dose is divided into two doses. So, each dose will be 2000 mg ÷ 2 = 1000 mg.

Step 4: Determine the number of tablets for each dose. Each tablet contains 500 mg of amoxicillin. So, the number of tablets for each dose is 1000 mg ÷ 500 mg/tablet = 2 tablets.

So, the nurse should administer 2 tablets of amoxicillin with each dose.

A. Hold the drug, and administer 4 hours later. B. Administer the vancomycin as ordered. C. Hold the drug, and notify the prescriber. D. Repeat the test to verify results.

Correct Answer is C

Explanation

Choice A rationale:

Holding the drug and administering it 4 hours later is not the appropriate action. The trough vancomycin level of 24 mcg/mL is higher than the recommended range of 10-20 mcg/mL, indicating potential risk for toxicity. Administering the drug later does not address the immediate concern of a high trough level.

Choice B rationale:

Administering the vancomycin as ordered is not the correct action in this case. The trough level is above the recommended range, which could lead to vancomycin toxicity. The nurse should not administer the medication without addressing the high trough level. Choice C rationale:

This is the correct action. The nurse should hold the drug and notify the prescriber because the trough vancomycin level is higher than the recommended range. The prescriber can then make a decision based on this information, which may include adjusting the dose, extending the dosing interval, or ordering additional tests.

Choice D rationale:

While repeating the test to verify results might be done eventually, it should not be the immediate next step. The nurse has a responsibility to ensure patient safety, and with a trough level above the recommended range, the priority is to prevent potential toxicity. Therefore, the nurse should hold the drug and notify the prescriber.

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When a patient is undergoing aminoglycoside therapy, which indicators should the nurse monitor for potential toxicity?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer amoxicillin 2 gm/day PO divided into two doses. The amount available is amoxicillin 500 mg tablets. How many tablets should the nurse administer with each dose?

Correct Answer is ["2 tablets."]

Explanation

The nurse checks the patient’s laboratory work prior to administering a dose of vancomycin and finds that the trough vancomycin level is 24 mcg/mL. What will the nurse do next?

Correct Answer is C

Explanation

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