A nurse is preparing to administer intermittent intravenous (IV) vancomycin to a client who has a methicillin-resistant Staphylococcus aureus (MRSA) wound infection. Which of the following actions should the nurse include in the medication administration process? (Select all that apply)
- Verify the client's most recent serum creatinine and blood urea nitrogen (BUN) levels.Answer
- Program the electronic infusion pump to deliver the medication over a minimum of 60 minutes.Answer
- CConnect the secondary medication tubing to the Y-site of an active total parenteral nutrition (TPN) infusion.
- DDelegate the pre-administration assessment of the IV insertion site to the unlicensed assistive personnel (UAP).
- Confirm that a serum trough level was drawn just prior to initiating the dose.Answer
Answer
The correct actions are verifying renal function labs (BUN and creatinine), infusing the medication over at least 60 minutes, and confirming that a serum trough level was drawn prior to the dose.
Vancomycin is a high-alert antibiotic that requires strict nursing protocols to prevent harm. Because it is nephrotoxic, baseline and ongoing monitoring of BUN and creatinine is essential. The drug has a narrow therapeutic window, meaning trough levels must be evaluated just prior to administration to prevent toxicity. Finally, to prevent a histamine-mediated infusion reaction known as Red Man Syndrome, vancomycin must always be administered via an electronic infusion pump over a minimum of 60 minutes.
Step-by-Step Solution
Key Concept
Safe administration of high-alert parenteral antibiotics (Vancomycin) including monitoring, rate control, and IV compatibility.