A patient is being treated with chloramphenicol (Chloromycetin) for an infection that has not responded to other antibacterial agents. A blood sample is drawn for determination of a serum trough level of the drug
The level is reported as 15 mcg/mL. The nurse's priority action is to
a. administer the drug as scheduled.
b. request that the laboratory perform a confirming test.
c. withhold the drug and notify the prescriber.
d. expect the prescriber to increase the dose for subsequent administrations.
ANS: C
The nurse should withhold the drug and notify the prescriber, because a trough level of 15 mcg/mL is high and may lead to aplastic anemia. The normal trough level is 5 to 10 mcg/mL.
The drug should not be administered as scheduled.
Nothing indicates that the measurement should be repeated.
An increase in the dose definitely would not be indicated, because the trough level is already high.
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