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47 Cards in this Set
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A woman is experiencing periods of increased anxiety and panic attacks over her illness and that of her family members. Epinephrine and norepinephrine are released. What glucocorticoid is released by the adrenal cortex in response to stress? a) insulin b) glucose c) thyroid hormone d) cortisol |
Ch 15 D. The increased activity of the sympathetic nervous system, which assists in the body’s response to stress, stimulates the release of cortisol. |
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A boy has contracted a rash caused by poison ivy over a large portion of his arms and legs following a camping trip. His healthcare provider has prescribed oral prednisone, which is to be administered in a tapering dose over the next 10 days. What effect does the medication have on the rash? a) it decreases the accumulation of neutrophils and macrophages at the site, thus reducing inflammation b) it eliminates the itching associated w/ the allergy c) it increases the WBC count to assist in healing D) it increases the protein metabolism to allow for the rejuvenation of tissue |
Ch 15 A. Prednisone decreases the infl ammatory response by reducing the accumulation of neutrophils and macrophages at sites of infl ammation. |
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A patient is receiving prednisone 10 mg orally everyday to reduce symptoms of Chron's disease. Which of the following effects is associated with daily administration of prednisone? A) atrophy of the adrenal cortex b) decreased serum glucose c) weight loss d) fluid vol deficit |
ch 15 A. The administration of systemic corticosteroids such as prednisone results in atrophy of the adrenal cortex |
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A patient w/ chronic obstructive pulmonary disease is being administered a corticosteroid by nebulizer. What effect does the corticosteroid have? a) decrease in blood pressure b) decrease in mucus secretion c) decrease in edema d) increase in immunity |
Ch 15 B. The administration of corticosteroids by nebulizer decreases mucus secretion and infl ammation in a patient with chronic obstructive pulmonary disease. |
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A patient is admitted to the ED in anaphylactic shock following numerous bee stings. The prescriber orders parenteral administration of corticosteroids. What effect is expected from the administration of these agents? a) decreases heart rate and blood pressure b) increases circulation to the lower extremities c) increased or restored cardiovascular responsiveness d) decreased production of aldosterone |
Ch 15 C. After "anaphylactic shock" resulting from an allergic reaction, corticosteroids may 'increase or restore cardiovascular responsiveness' to "adrenergic drugs". |
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A patient is taking fluticasone (flovent) 440 mcg inhaled 2x per day. The patient is being seen in the pulmonary clinic and says, "I have been very congested and it has been hard to breathe, so for the past 10 days I have been using my inhaler 4x per day)". The nurse should assess the patient for which of the following systemic effects? a) hypoglycemia b) hyperclacemia c) anxiety d) Hypothalmic-pituitary-adrenal (HPA) suppression |
Ch 15 D. Taking this dose of fl uticasone places the patient at risk for adrenocortical insuffi ciency from hypothalamic–pituitary–adrenal (HPA) suppression |
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A liver transplant patient is receiving corticosteroids. These drugs are important to the care of this patient because they a) prevent thrombocytopenia b) increase immunity c) prevent tissue rejection d) decrease inflammation |
ch 15 C. The administration of corticosteroids to patients after liver transplant "suppresses cellular and humoral immune responses" and helps prevent rejection of transplanted tissue. |
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A cancer patient asks the nurse why he is being given a corticosteroid before chemotherapy. Which of the following is the nurse's best response? a) It will prevent the development of anemia r/t the chemotherapy b) It will prevent the development of hiccups, which is associated w/ chemotherapy c) it will prevent nausea and vomiting that occurs w/ chemotherapy d) It will boost you immune system and prevent infection |
ch 15 C. The administration of corticosteroids before the administration of chemotherapy helps prevent nausea and vomiting, which is an adverse effect of chemotherapy |
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When administering long term systemic corticosteroid medications, which of the following dosing schedules is recommended? A) alternate day therapy B) once daily at noon C) weekly therpay D) nightly therapy |
Ch 15 A. It is recommended that systemic corticosteroid medications be administered on alternate days. The dose administered is two times the normal daily dose. |
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A child is taking long term systemic corticosteroids. What factor influences the child's diminished growth? a) hypokalemia b) fluid retention c) altered DNA synthesis d) increase in parathyroid hormone |
ch 15 C. Corticosteroids alter the synthesis of DNA, resulting in diminished growth |
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A woman is being treated w/ long term corticosteroid therapy. Her husband has just received a diagnosis of terminal cancer. How is his diagnosis likely to affect her treatment? A) she may need to have her dose of corticosteroid increased because of her stress b) she may need a decrease in corticosteroids b/c of the increase in cortisol c) she may need to be changed to a different corticosteroid because of stress d) she may be switched to a parenteral form of corticosteroid |
ch 15 A. The woman will most likely require a larger dose of corticosteroid as a result of her husband’s diagnosis. Periods of increased stress require larger doses of corticosteroids |
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A patient w/ Addison's disease is taking exogenous corticosteroid. The nurse should assess the patient for which of the following adverse effects? A) hyperglycemia B) hyperkalemia c) hypercalcemia d) hypermagnesemia |
ch 15 A. The administration of systemic corticosteroids leads to an increase in blood glucose. The nurse should assess the patient for hyperglycemia. |
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Which of the following psychosocial changes are most likely to occurs w the administration of corticosteroids? A) lethargy b) malaise c) ataxia d) euphoria |
Ch 15 D. Patients receiving systemic corticosteroids may experience euphoria, insomnia, and psychosis. |
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A patient is taking systemic corticosteroids. Which of the following nursing interventions is most important to implement? A) assess for s/s of adrenocortical excess B) hold the corticosteroid before surgery or diagnosic testing C) assess for fluid volume deficit D) decrease the intake of vitamin C |
Ch 15A. The nurse should assess the patient receiving systemic corticosteroid therapy for adrenocortical excess.
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A critically ill patient is receiving gentamicin 1.5 mg kg IV every 8 hours. The patient has recently stopped making urine, and the most recent laboratory result indicate that the patient's creatinine level has risen from a normal value of 0.8 mg/dl to 3.6 mg/dl. At the next scheduled time for administration of gentamicin the nurse should A) Administer half the prescribed dose B) hold the gentamicin and notify the physician C) Administer the gentamicin as prescribed D) draw a blood sample for testing the gentamicin trough level before the dose and then administer as prescribed. |
Ch 17 B. Gentamicin is excreted via the kidneys, and alterations in renal function may cause nephrotoxicity. Possible nephrotoxicity is a well-known adverse effect of gentamicin, and in this case, the nurse should notify the physician. A and C are incorrect because the patient could be experiencing renal impairment, and giving more gentamicin, even half the dose, may still cause drug toxicity and nephrotoxicity. D is incorrect because gentamicin could be contributing to the renal impairment. Although obtaining a trough level might help evaluate the gentamicin regimen, the nurse should not administer the drug until he or she discusses it with the physician |
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A Physician writes an order for gentamicin 7 mg/kg Intravenously every 24 hours and ampicillin 500 mg intravenously every 6 hours. The patient has a diagnosis of endocarditis. This is not an ideal antibiotic regimen for endocarditis because. a) It is best to use multiple daily dosing of gentamicin for endocarditis b) the addition of gentamicin to ampicillin increases the risk of treatment failure in endocarditis C) the appropriate single daily dose of gentamicin is 15 mg per kg once daily D) streptomycin is the recommended aminoglycoside for use in endocarditis. |
Ch 17 A." Once-daily aminoglycoside dosing" is 'contraindicated' in patients with 'endocarditis', and only the conventional dosing regimen should be used. B is incorrect because gentamicin and ampicillin are recommended in endocarditis, and they increase the risk of treatment success, not failure. C is incorrect because the single daily dose of gentamicin is a maximum of 7 mg/kg, not 15 mg/kg, once daily. D is incorrect because streptomycin is not the recommended aminoglycoside for use in endocarditis. |
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A patient from a nursing home arrives at the emergency department with acute pyelonephritis. The physician prescribes ciprofloxacin 500 mg PO twice daily. The patient has a history of seizures and bradycardia. The Nurse should: a) counsel the patient's caregiver to avoid administering the ciprofloxacin with the patient's anticonvulsant b) ask the physician to check blood levels of the patient's anticonvulsants before giving the first dose of ciprofloxacin. c) call the patient's seizure and dysrhythmia history to the physician's attention and inquire whether another type of antibiotic might be selected. d) counsel the patient's caregiver to discontinue the ciprofloxacin after the patient's fever is gone |
Ch 17 C. The addition of ciprofl oxacin has led to documented drug interactions with anticonvulsants and antidysrhythmics, and the prescriber should choose an alternative if possible. A is incorrect because the patient needs to take the anticonvulsant for seizures as well as an antibiotic for pyelonephritis. Altering the administration schedule may precipitate seizures. B is incorrect because even if levels are obtained, it is the concurrent administration ciprofl oxacin that can alter the levels of the anticonvulsant. In addition, an interaction with the antidysrhythmic agent may prolong the QT interval. D is incorrect because all antibiotics should be taken for the entire duration of therapy, even if the patient feels better or the fever is gone |
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A nurse reading a patient's chart notices that the patient is scheduled to receive ciprofloxacin 500 mg PO at 9am. The medication administration record also indicates that Maalox 30 ml PO and hydrochlorothiazide 25 mg PO are due at 9 AM. The nurse should A) administer all the medications as scheduled. B) hold the Maalox until 11 am c) ask the physician to discontinue hydrochlorothiazide because of increased risk of ototoxicity. d) administer the Maalox and ciprofloxacin but hold the hydrochlorothiazide |
Ch 17 B. Ciprofl oxacin can chelate with cations, and iron, multivitamins, calcium, magnesium, aluminum salts, and sucralfate may signifi cantly reduce the absorption of ciprofl oxacin. Therefore, ciprofl oxacin should be taken 2 hours before or 6 hours after administration of the other agents. A is incorrect because Maalox impairs the absorption of ciprofl oxacin. C is incorrect because loop diuretics, not thiazide diuretics, potentiate the effects of nephrotoxicity. D is incorrect because of the interaction with Maalox and ciprofl oxacin. Thiazide diuretics do not interact with ciprofl oxacin like loop diuretics do |
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An outpatient has just received a prescription for ciprofloxacin 500 mg PO twice daily for acute bronchitis. The nurse should teach the patient A) not to take the ciprofloxacin with a meal B) to restrict fluid intake to avoid fluid overload C) to take the ciprofloxacin with an antacid (e.g. TUMS) to decrease the chance of a stomach upset D) to avoid prolonged exposure to sunlight. |
Ch 17 D. Photosensitivity may occur with exposure to direct or indirect sunlight; therefore, the patient should avoid prolonged exposure to the sun. Sunscreens do not prevent photosensitivity reactions. A is incorrect because patients may take ciprofl oxacin with food to avoid gastrointestinal upset. B is incorrect because adequate fl uid intake should accompany a ciprofl oxacin dose to prevent drug crystals from forming in the urinary tract. C is incorrect because ciprofl oxacin interacts with antacids, resulting in impaired ciprofl oxacin absorption. |
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A nurse is preparing to administer the first dose of piperacillin-tazobactam (Zosyn) to a patient in an infusion clinic. The nurse should take which of the following precautions? A) Ask the patient about past allergic reactions to penecillins B) Ask the patient about past allergic reactions to aminoglycosides. C) Mix the piperacillin-tazobactam w/ lidocaine to reduce pain of infusionD) Instruct the patient to eat a snack to decrease stomach upset from piperacillin-tazobactam |
Ch 16A. Penicillin allergy is the most common cause of druginduced anaphylaxis. Piperacillin–tazobactam (Zosyn) is a combination product containing an extended-spectrum antipseudomonal penicillin and a beta-lactamase inhibitor. Cross-allergenicity occurs among all the penicillins; therefore, asking the patient about past reactions to penicillins is a necessary intervention before giving this medication. Drug administration is intravenous; thus, it is unlikely to cause stomach upset. After diluting the drug in intravenous fl uid, administration occurs slowly through a small-bore needle in a large vein to prevent vein irritation and pain during infusion. It is important to monitor the site and ensure that it remains patent throughout the administration
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A woman is to receive amoxicillin-clavulanate (Augmentin) 500 mg PO every 8 hours for bronchitis. The nurse retrieves two 250 mg tablets from the medication cart. This is incorrect for which of the following reasons A) The amount of sulbactam in amoxicillin-clvaulanate 250 mg is 62.5 mg per tablet, twice the intended amount B) This provides twice the intended dose of clavulanate C) The 250 mg tablets have less absorption than the 500 mg tablet D) Administration of amoxicillin clavulanate is only intravenous, so selecting tablets mean that the wrong drug is being administered |
Ch 16B. Amoxicillin–clavulanate (Augmentin) is an orally administered combination product containing the antibiotic amoxicillin and the beta-lactamase inhibitor clavulanate. It is available in 250-, 500-, and 875-mg tablets; each of which contains 125 mg of clavulanate. Administering two 250-mg tablets of Augmentin provides an overdosage (250 mg) of clavulanate
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A cardiac surgeon orders cefazolin 1 g IV "on call" to the operating room for a patient scheduled for a heart valve replacement. The surgery is scheduled for 7:00 AM the next morning. What is the rationale for giving the antibiotic at 630 AM? The last dose was administered more than 8 hours ago. A) The cefazolin must be given 60 minutes before the procedure for legal reasons B) The cefazolin must be given within 60 minutes before the first skin incision to reach therapeutic concentrations C) The cefazolin trough level will be checked a 600 am, which would allow the level to come back before administration of the 'on call' doseD) The last dose was administered yesterday. |
ch 16B. Research has demonstrated that antibiotics must be 'present in the patient' when the first skin incision to provide the most protection against infections acquired during surgery. That means that most antibiotics are ideally given no more than 1 hour before, not after, the fi rst skin incision.
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Which of the following classes of cephalosporins has the best activity against gram positive organisms? A) first generation cephalosporinsB) second generation cephalosporinsC) third generation cephalosporinsD) fourth generation sephalosporins |
Ch 16A. First-generation cephalosporins are primarily effective against gram-positive bacteria. Second-generation cephalosporins are more active against gram-negative bacteria than fi rst-generation drugs. Third-generation cephalosporins further extend the spectrum of activity against gram-negative organisms. Fourth-generation cephalosporins are the broadest of all in spectrum acting against some gram-positive and many gram-negative organisms, including greater stability against degradation by beta-lactamase enzymes.
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A nurse working in the neurointensive care unit is caring for a patient with a head injury who has been experiencing seizures and now has pneumonia caused by pseudomonas aeruginosa. The physician has prescribed imipenem 1 g IV every 6 hours plus gentamicin for the pneumonia. Before administering the antibiotics, the nurse should do which of the following? A) Avoid mixing the imipenem and gentamicin in the same IV bag to prevent inactivation of gentmicin B) remind the physician of the patient's seizures and inquire whether a different antibioitic might be safer. C) suggest to the physician that imipenem is used to treat gram positive infections and will not be effective in this patient. D) set the infusion pump to deliver the imipenem over 15 minutes |
Ch 16B. An adverse effect of imipenem is "central nervous system toxicity" including "seizures", which is undesirable for this patient with a head injury and seizure activity. Although imipenem may be given concomitantly with gentamicin, mixing these drugs together in the same IV fl uid inactivates the gentamicin. Imipenem is a" broad-spectrum antibiotic" that should be infused over 40 to 60 minutes.
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In acute renal failure, doses of which of the following antibiotics must be reduced?A) nafcillinB) cefazolinC) meropenemD) aztreonam.
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ch 16B, C, and D. Cefazolin, meropenem, and aztreonam all "rely on renal clearance", and their dosages must be "reduced in acute renal failure". The elimination of nafcillin does not entirely rely on renal clearance, because it is 60% metabolized by the "liver".
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A Patient is admitted to the emergency department opening an envelope containing a substance that experts have identified as anthrax. Which of the following medications is administered? A) tetracycline B) doxycycline C) amoxicillin-clavulanic acid combination D) neomycin |
Ch 18 B. Patients who are asymptomatic receive doxycycline or ciprofloxacin for 60 days following exposure to anthrax. |
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A patient receiving tetracycline should receive the following instruction regarding the medication? A) Take tetracycline with food B) Take tetracycline in combination with antacids C) take the first dose and then obtain a test known as culture and sensitivity D) take tetracycline with a full glass of water |
Ch 18 D. Tetracycline should be taken with a full glass of water. |
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Which of the following foods should not be taken with tetracycline? A) orange juice with calcium B) cranberry juice cocktail C) tomato juice D) lemonade |
Ch 18 A. Tetracycline is contraindicated with calcium or dairy products |
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A man is receiving treatment for mycoplasma pneumonia infection. He says that drinking orange juice hurts his mouth. What priority assessment should the nurse make? A) assess the patient's fecal output for s/s of diarrhea. B) assess the patient's mouth for signs of candida infection C) assess the patient's lung sounds for rales or ronchi D) assess the patient's intake and output |
Ch 18 B. When a patient complains of mouth pain and diffi culty swallowing when taking an antiinfective agent such as tetracycline, it is necessary to inspect the patient’s mouth for white patchy areas. These areas indicate Candida albicans, a superinfection of the mouth |
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Which laboratory value should the nurse assess in patients who are receiving demeclocycline? A) Blood urea nitrogen B) Aspatate aminotransferase C) alanine aminotransferase D) creatinine |
Ch 18 A. When administering demeclocycline, it is important to monitor the patient’s blood urea nitrogen (BUN). Increases in the BUN are secondary to antianabolic effects. |
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A woman develops a UTI following the delivery of an infant. The NP is considering prescribing trimethoprim-sulfamethoxazole. What" assessment" is necessary to make? A) if the woman is breast-feeding B) if the woman has been treated with the medication in the past. C) if anyone in her family has a known allergy to the drug D) if she is experiencing hematuria. |
Ch 18 A. It is important to assess if the woman is breast-feeding. If a fetus or young infant receives a sulfonamide by placental transfer, in breast milk, or by direct administration, the drug displaces bilirubin from binding sites on albumin. As a result, bilirubin may accumulate in the bloodstream (hyperbilirubinemia) and central nervous system (kernicterus), causing life-threatening toxicity. |
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When administering a sulfonamide, which of the following interventions is most effective in decreasing crystalluria? a) administering 8 ounces of cranberry juice. b) providing a full liquid diet during the course of drug therapy. c) inserting a foley catheter for the measurement of an accurate intake and output d) providing a minimum of 2000 ml of fluid per day |
Ch 18 D. To prevent crystalluria, it is essential that patients receive 2000 mL of fl uids in a 24-hour period |
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A physician has ordered sulfisoxazole for a woman with a UTI. The nurse has asked the patient about whether she takes any over the counter medications. The patient reports that she regularly takes St. John's Wort as a mood elevator. Which of the following patient teaching interventions is most important? a) taking St. John's Wort and sulfisoxazole results in no known interactions b) sulfisoxazole combined with St John's wort leads to an increased therapeutic effect of sulfisoxazole c) sulfisoxazole has a decreased effect when given with St. John's Wort. d) when given in combination, sulfisoxazole and St. John's wort results in manic tendencies. |
Ch 18 B. When taken concurrently with sulfi soxazole, St. John’s wort enhances the effects of the sulfi soxazole. |
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A nurse is applying sliver sulfadiazine (silvadene) to a child's burns. Which of the following nursing actions is most important when applying the medication? A) providing pain medications B) Using sterile gloves C) giving the child a bath D) teaching the parent to apply the medication |
Ch 18 B. When applying silver sulfadiazine (Silvadene) to a burned area, it is important to wear sterile gloves |
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A physician has ordered intravenous sulfamethoxazole with trimpethoprim. How should the nurse administer the medication? a) in 500 ml of 0.45% normal saline b) in 150 ml of 10% dextrose and water c) in 125 ml of 5% dextrose and water d) in 125 ml of 5% dextrose and 0.45% normal saline |
Ch 18 C. When administering sulfamethoxazole and trimethoprim intravenously, it is necessary to dilute the medication in 125 mL of 5% dextrose and wate |
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A nurse practitioner has prescribed nitrofurantoin (Macrodantin) for a woman w/ a UTI. which of the following cardiovascular adverse effects is this patient at risk for developing? A) inverted T wave B) Widened QRS C) premature ventricular contraction (PVC) D) bundle branch block |
Ch 18 D. Bundle branch block and changes in the ST and T waves are cardiac-related adverse effects of nitrofurantoin. |
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A man has had a UTI, and a prescriber orders phenazopyridine (Pyridium). Which of the following adverse effects should he report to his health care provider? A) yellowing of the skin B) edema C) pain D) Malaise |
Ch 18 A. Yellowing of the skin indicates an accumulation of phenazopyridine |
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A patient is admitted to the critical care unit with a diagnosis of 'Leigonnaire's disease'. Based on your knowledge of pharmacology, which medication is the drug of choice to treat the infection? A) Azithromycin B) Clarithromycin C) Erythromycin D) Vancomycin |
Ch 19 C. Parenteral erythromycin is the drug of choice for the treatment of Legionnaire’s disease |
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A nurse instructs a patient on the administration of Clarithromycin. Which of the following patient teaching instructions is appropriate? A) Take the medication on an empty stomach. B) Take the medication with a calcium supplement C) Take the medication with a class of milk D) Take the medication with cheese |
Ch 19 A. Patients should take azithromycin on an empty stomach. The other choices all involve combination with a calcium-containing substance, which should not be administered with azithromycin. |
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A teenage boy receives a prescription for erythromycin for an upper respiratory tract infection. He complains that he cannot hear the teacher, who then sends him to the school nurse's office. After assessing the patient's hearing with a tuning fork, the nurse determines that his hearing is diminished. What is the most important nursing intervention? A) The nurse should notify the parents to call the physician; this is an adverse effect of erythromycin. B) The nurse should inform the parents of a physician who specializes in ear, nose, and throat surgery C) The nurse should instruct the patient to stop taking the erythromycin and his hearing will improve. D) The nurse should call the physician and inform the patient of a change in antibiotics. |
Ch 19 A. After the nurse assesses the patient’s hearing, it is important to notify the patient’s family of the hearing loss and tell the parents to notify the physician, because this is an adverse effect of erythromycin. The nurse does not have the authority to discontinue the erythromycin but needs to play a role in notifying the prescriber of the hearing loss. |
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A parent of a high school student calls the school nurse regarding her daughter's crying. The parent states that this behavior is unusual for her daughter. Which of the following medications contribute to changes in behavior? A) metronidazole B) naproxen sodium C) vitamin C D) erythromycin |
ch 19 D. Changes in behavior with crying or laughing is an adverse effect of erythromycin |
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A man had rheumatic fever as a child. He has an appointment for a tooth extraction. His dentist prescribes which of the following medications prior to the extraction? A) chloramphenicol B) vancomycin C) clarithromycin D) Digoxin |
Ch 19 C. Clarithromycin is the prophylactic drug of choice for patients who are predisposed to cardiac endocarditis. Patients who have had rheumatic fever are at risk for the development of this infectious cardiac condition. |
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Which of the following adverse effects of telithromycin indicates a superinfection? A) diarrhea B) bloody diarrhea C) nausea D) vomitting |
Ch 19 B. The development of bloody diarrhea is a symptom of pseudomembranous colitis, which is a superinfection. |
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Torsades de pointes is a lengthened QT interval. Which of the following medications combined with telithromycin results in this condition? A) acetaminophen B) naproxen sodium C) regular insulin D) ciprofloxacin |
Ch 19 D. The combination of ciprofl oxacin and telithromycin leads to a prolonged QT wave |
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A patient is prescribed telithromycin 800 mg orally for community acquired pneumonia. Prior to administering the medication, the nurse reviews the patient's laboratory values. Which of the following laboratory values would recommend a reduction in dosage to 400 mg? (SATA) A) creatinine, 3.3 mg per dl B) alanine aminotransferase, 98 unit per L C) aspartate aminotransferase, 60 unit per L D) sodium, 145 mEq per L |
Ch 19 A, B, and C. The creatinine, alanine aminotransferase, and aspartate aminotransferase are all elevated, indicating diminished renal and hepatic function. It is necessary to reduce the telithromycin dosage in the presence of renal and hepatic impairment |
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A nurse practitioner sees a 19 y/o college student in the student health center for severe diarrhea. The nurse diagnoses travelers' diarrhea based on the young woman's history'; she had recently returned from Mexico. She receives a prescription for rifaximin 200 mg orally three times daily for 3 days. Four days later, she calls the office and reports to the nurse that she has a fever and that the diarrhea has not resolved. Which of the following is the most appropriate information to communicate to the student? A) Advise the student to return to the clinic for further tests and a different antibiotic. B) Call the Pharmacy and authorize one refill of rifaximin. C) Advise the student that it takes up to 48 to 72 hours after the completion of treatment for the diarrhea to completely resolve D) Tell the student to continue to drink plenty of fluids and report back in 24 hours. |
Ch 19 A. The student should be advised to return to the clinic. After treatment with rifaximin begins, patients report worsening or persistent diarrhea for longer than 24 to 48 hours, fever, or blood in the stool, which should be treated with an alternative agent. |
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A recent nursing graduate is preparing to administer vancomycin to a man intravenously. The nurse states the patient reported that he experienced flushing with his last dose of vancomycin. The nurse should. A) infuse the vancomycin over 30 minutes to decrease the chance of a reaction B) hold the vancomycin dose until the physician's rounds the following morning C) dilute the vancomycin in 50 ml of normal saline solution and infuse over 60 minutes. D) contact the physician, report the reaction, and request an order for diphenhydramine pretreatment. |
Ch 19 C. When administering intravenous vancomycin, it is necessary to dilute 500-mg doses in 100 mL and 1-g doses in 200 mL of 0.9% NaCl or 5% dextrose injection and infuse over at least 60 minutes. |
