A nurse is caring for a client receiving an intermittent IV bolus of gentamicin twice daily. Which of the following laboratory values should the nurse monitor while the client is receiving this medication? (Select all that apply.)
Glucose.
Prothrombin time.
Serum creatinine.
Cardiac enzymes.
WBC count.
Correct Answer : C,E
Choice A rationale
Monitoring glucose levels is not typically necessary for patients receiving gentamicin, as it does not significantly affect glucose metabolism.
Choice B rationale
Prothrombin time is not commonly affected by gentamicin, so routine monitoring is not required.
Choice C rationale
Serum creatinine levels should be monitored to assess kidney function, as gentamicin can cause nephrotoxicity.
Choice D rationale
Cardiac enzymes are not typically affected by gentamicin, so routine monitoring is not necessary.
Choice E rationale
Monitoring WBC count is important to detect any signs of infection or bone marrow suppression, which can occur with gentamicin use.
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Correct Answer is C
Explanation
Choice A rationale
A standing prescription is an order that applies to all patients who meet certain criteria and is not specific to a single administration. It is used for routine treatments and does not apply to a one-time pre-transfusion medication.
Choice B rationale
A stat prescription is an urgent order that requires immediate administration, typically within minutes. It is used for emergency situations and does not apply to a pre-transfusion medication given one hour before the procedure.
Choice C rationale
A single prescription is a one-time order for a specific medication to be given at a specific time. In this case, diphenhydramine 50 mg by mouth once, one hour prior to transfusion, fits the definition of a single prescription.
Choice D rationale
A PRN (pro re nata) prescription is an order for medication to be given as needed based on the patient’s condition. It is not applicable to a scheduled pre-transfusion medication.
Correct Answer is C
Explanation
Choice A rationale
Incorrect packaging, such as a topical medication packaged as an oral medication, can lead to medication errors. However, it is not the most frequent cause of fatal medication errors. Packaging errors are relatively rare and usually caught before administration.
Choice B rationale
Delivery device problems, such as an infusion pump malfunction, can cause medication errors. These errors can be serious but are not the most frequent cause of fatal medication errors. Device malfunctions are often detected and corrected by healthcare professionals.
Choice C rationale
Name confusion between two medications with similar sounding names is the most frequent cause of fatal medication errors. This type of error occurs when medications with similar names are confused, leading to the administration of the wrong drug. This can have serious and sometimes fatal consequences.
Choice D rationale
Incorrect labeling of a medication dispensed by the pharmacy can lead to medication errors. While labeling errors are a significant concern, they are not the most frequent cause of fatal medication errors. These errors are often identified and corrected before administration.