Test Bank for Pharmacology 10th Edition by Mccuistion

TEST BANK FOR PHARMACOLOGY 10TH EDITION BY MCCUISTION

31. The nurse is caring for a 70-kg patient who is receiving gentamicin (Garamycin) 85 mg 4 times daily. The patient reports experiencing ringing in the ears. The nurse will contact the provider to discuss which of the following? a. decreasing the dose to 50 mg QID. b. giving the dose 3 times daily. c. obtaining a serum drug level. d. ordering a hearing test. ANS: C Aminoglycosides can cause ototoxicity. Any changes in hearing should be reported to the provider so that serum drug levels can be monitored. The dose is correct for this patient’s weight (5 mg/kg/day in 4 divided doses). A hearing test is not indicated unless changes in hearing persist. DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Evaluation/Nursing Intervention MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 32. The nurse is preparing to begin a medication regimen for a patient who will receive intravenous ampicillin and gentamicin. Which is an important nursing action? a. Administer each antibiotic to infuse over 15 to 20 minutes. b. Order serum peak and trough levels of ampicillin. c. Prepare the schedule so that the drugs are given at the same time. d. Set up separate tubing sets for each drug labeled with the drug name and date. ANS: D Intravenous aminoglycosides can be given with penicillins and cephalosporins but should not be mixed in the same container. The IV line should be flushed between antibiotics, or separate tubing sets may be set up. Gentamicin must be infused over 30 to 60 minutes. It is not necessary to measure ampicillin peak and trough levels. Giving the drugs at the same time increases the risk of mixing them together. DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Nursing Intervention MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 33. The nurse is reviewing a patient’s chart prior to administering gentamicin (Garamycin) and notes that the last serum peak drug level was 9 mcg/mL and the last trough level was 2 mcg/mL. What action will the nurse take? a. Administer the next dose as ordered. b. Obtain repeat peak and trough levels before giving the next dose. c. Report possible drug toxicity to the patient’s provider. d. Report a decreased drug therapeutic level to the patient’s provider. ANS: C Gentamicin peak values should be 5 to 8 mcg/mL, and trough levels should be 0.5 to 2 mcg/mL. Peak levels give information about whether or not a drug is reaching potentially toxic levels, while trough levels indicate whether a therapeutic level is maintained. This drug is at a toxic level, and the next dose should not be given. DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Evaluation