A nurse is caring for a client who has a prescription for vancomycin 1 g IV intermittent infusion over 30 min every 12 hr. Which of the following actions should the nurse take?
Request a serum trough level blood draw for 60 min after completion of infusion.
Change the infusion site after each dose administration.
Contact the provider for prescription clarification.
Request a serum peak level to be drawn 30 min prior to infusion.
The Correct Answer is A
Rationale:
A. Requesting a serum trough level blood draw for 60 minutes after the completion of the infusion is appropriate for monitoring the therapeutic levels of vancomycin and ensuring it is within the desired range to prevent toxicity.
B. Changing the infusion site after each dose administration is not necessary unless there is an issue such as infiltration or phlebitis; typically, the site can be used for multiple doses if it remains patent and functional.
C. Contacting the provider for prescription clarification is not needed unless there are specific concerns about the medication or the administration protocol; in this case, the order is clear and standard.
D. Requesting a serum peak level to be drawn 30 minutes prior to infusion is incorrect, as the peak level should be drawn 30 minutes after the completion of the infusion, not before the next dose.
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Correct Answer is A
Explanation
Rationale:
A. "Leuprolide decreases the production of testosterone.": Leuprolide is a gonadotropin-releasing hormone (GnRH) agonist that works by reducing testosterone production, which is essential for the growth of prostate cancer cells. This mechanism slows the progression of the cancer.
B. "Leuprolide kills cells at all stages of cellular division.": This describes how chemotherapy drugs work, but leuprolide does not function by directly killing cancer cells at different stages of their division.
C. "Leuprolide increases estrogen levels in your body to counteract the cancer cells.": Leuprolide does not increase estrogen levels. Instead, it reduces testosterone levels, which is more effective in managing prostate cancer.
D. "Leuprolide suppresses the pituitary gland's production of growth hormone to decrease cancer cellular growth.": Leuprolide suppresses the production of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), not growth hormone, to decrease testosterone levels.
Correct Answer is D
Explanation
Rationale:
A. Verapamil is a calcium channel blocker that typically decreases heart rate rather than increases it. Therefore, an increased heart rate would not be a therapeutic response to this medication.
B. Verapamil works to lower blood pressure by inhibiting calcium influx into the vascular smooth muscle. An increase in blood pressure would not be an expected therapeutic outcome.
C. While verapamil may help with heart function, the primary therapeutic response is not specifically measured by decreased pulmonary congestion. This outcome may not be directly observable in the early treatment phases post-myocardial infarction.
D. Verapamil is effective in reducing anginal pain by decreasing myocardial oxygen demand through lowering heart rate and contractility. Thus, a decrease in anginal pain would be a direct therapeutic response to the medication.