What interventions do you need to implement to safely administer vancomycin? Select all

Question

that apply.

a. Hold the infusion if J.L. complains of tinnitus
b. Obtain a trough level 6 hours after each infusion
c. Monitor urine output, BUN, and creatinine levels
d. Anticipate replacing the PICC line every 48 hours
e. Administer each infusion over a minimum of 1 hour
f. Assess for the onset of hypertension during the infusion

Answer 1

a, c, e
To assist in titrating dosages to therapeutic levels, trough levels are monitored during therapy.
Draw blood samples for measuring trough levels immediately before administering the next dose.
Too-rapid IV injection of vancomycin can cause a condition known as red man syndrome or red neck
syndrome. Characterized by red blotching of the face, neck, and chest, this is a toxic effect rather
than an allergic reaction. These effects can usually be avoided by infusing vancomycin over 60
minutes or more. Vancomycin is associated with a number of side effects. Because ototoxicity can
be permanent, you would hold the infusion and notify the physician immediately if the patient
complains of dizziness or tinnitus. Monitor the blood pressure during the infusion because severe
hypotension can occur. To monitor for nephrotoxicity, assess urine output and BUN and creatinine
levels. To reduce the risk of thrombophlebitis, the infusion site needs to be changed frequently, but
only when using a peripherally inserted catheter.