The nurse assumes care for a patient who is currently receiving a ...

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The nurse assumes care for a patient who is currently receiving a dose of intravenous vancomycin (Vancocin) infusing at 20 mg/min.
 
  The nurse notes red blotches on the patient's face, neck, and chest and assesses a blood pressure of 80/55 mm Hg. Which action will the nurse take?
  a. Request an order for IV epinephrine to treat anaphylactic shock.
  b. Slow the infusion to 10 mg/min and observe the patient closely.
  c. Stop the infusion and obtain an order for a BUN and serum creatinine.
  d. Suspect Stevens-Johnson syndrome and notify the provider immediately.

Question 2

The nurse is caring for a patient who is receiving a high dose of tetracycline (Sumycin). Which laboratory values will the nurse expect to monitor while caring for this patient?
 
  a. Blood urea nitrogen (BUN) and creatinine levels
  b. Complete blood counts
  c. Electrolytes
  d. Liver enzyme levels

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Answer to Question 1

ANS: B
When vancomycin is infused too rapidly, red man syndrome may occur; the rate should be 10 mg/min to prevent this. This is a toxic reaction, not an allergic one, so epinephrine is not indicated. Stevens-Johnson syndrome is characterized by a rash and fever. Red man syndrome is not related to renal function.

Answer to Question 2

ANS: A
High doses of tetracyclines can lead to nephrotoxicity, especially when given along with other nephrotoxic drugs. Renal function tests should be performed to monitor for nephrotoxicity.

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