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 D
Explanation
Rationale:
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B. Amphotericin B: Amphotericin B is an antifungal agent used to treat serious fungal infections, not bacterial UTIs.
C. Azithromycin: Azithromycin is an antibiotic that is effective against a broad range of bacterial infections but is not commonly used for treating recurrent UTIs.
D. Nitrofurantoin: Nitrofurantoin is an antibiotic commonly used to prevent and treat recurrent lower urinary tract infections due to its efficacy in targeting the bacteria that typically cause UTIs.
Correct Answer is D
Explanation
Rationale:
A. This statement is incorrect because the client should remove contact lenses before administering brimonidine and wait at least 15 minutes before reinserting them to ensure proper absorption and avoid irritation.
B. While some mild irritation can occur, it is not a desired effect and should not be expected; the nurse should clarify what level of irritation is considered normal.
C. This statement is incorrect as brimonidine is typically a long-term treatment for glaucoma, and clients should not stop using it without consulting their provider.
D. This statement is correct; brimonidine can cause changes in eye color, particularly in individuals with lighter colored eyes, and the client should be informed about this possibility.