An older adult client with sepsis has been admitted to the ...

[tingc95]

An older adult client with sepsis has been admitted to the nursing unit. The nurse is planning care and determines that one goal for this client is to maintain normal mental status.
 
  Which outcome evaluation implies that the goal has been met?
  A) The client is agitated.
  B) The client has a Glasgow coma score of 4.
  C) The client responds to questions appropriately.
  D) The client's pupils are fixed and dilated.

Question 2

The healthcare provider prescribes a client to have peak and trough blood levels drawn to evaluate the therapeutic effect of an IV antibiotic. When should the nurse schedule the blood samples to be drawn?
 
  Select all that apply.
  A) Prior to the discontinuing the antibiotic
  B) A few minutes before the next scheduled dose of medication
  C) During the infusion of the antibiotic
  D) 30 minutes after the IV administration
  E) 1-2 hours after the oral administration of the medication

[itsakadoozi]

Answer to Question 1

Answer: C

A client who responds to questions appropriately is alert and oriented. Restlessness or agitation in a client with sepsis can be a sign that the client's condition is deteriorating. The client with a Glasgow coma score of 4 is comatose. When pupils are fixed and do not respond to light, death is imminent.

Answer to Question 2

Answer: B, D

Antibiotic peak and trough levels monitor therapeutic blood levels of the prescribed medication. The therapeutic range-that is, the minimum and maximum blood levels at which the drug is effective-is known for a given drug. By measuring blood levels at the predicted peak (1-2 hours after oral administration, 1 hour after intramuscular administration, and 30 minutes after IV administration) and trough, usually a few minutes before the next scheduled dose, it is also possible to determine whether the drug is reaching a toxic or harmful level during therapy, increasing the likelihood of adverse effects.