A nurse has just initiated an intravenous piggyback of gentamicin ...

[jon_i]

A nurse has just initiated an intravenous piggyback of gentamicin (Garamycin). What is the best time for a trough serum level to be measured?
 
  a. Just before the next dose
  b. When the infusion is finished
  c. One hour after the medication is administered
  d. Depends on the specific medication

Question 2

Which is the most important nursing action before discharge for a mother who is apprehensive about giving her child insulin?
 
  a. Review the side effects of insulin with the mother.
  b. Have the mother verbalize that she knows the importance of follow-up care.
  c. Observe the mother while she administers an insulin injection.
  d. Help the mother devise a rotation schedule for injections.

[amcvicar]

Answer to Question 1

A
The medication trough is the level at which the serum concentration is lowest. Trough levels are usually obtained just before the next medication dose. The serum concentration would be increasing as the infusion finishes. This is not the concentration trough. The peak concentration, or the concentration after the medication has been distributed, varies according to the specific medication. Trough is always the lowest just before the next medication dose.

Answer to Question 2

C
It is important that the nurse evaluate the mother's ability to give the insulin injection prior to discharge. Watching her give the injection to the child will give the nurse an opportunity to offer assistance and correct any errors. Although reviewing side effects is important, this could be done over the phone or by the pharmacist when the medication is picked up. Having the mother verbalize her knowledge of the importance of follow-up care is important but not directly relevant to the mother's concern. Helping the mother devise a rotation schedule for injections is important but not as important as having the mother demonstrate the procedure.

[jon_i]

Thank you

[amcvicar]

Happy to help you