A nurse is planning to administer vancomycin IV to a client. Which of the following actions should the nurse take to reduce the risk of an adverse reaction to the vancomycin?
Explanation & Rationale
A. Obtain a trough level 30 min after the medication infusion: Trough levels should be drawn just before the next dose, not 30 minutes after the infusion. This timing ensures accurate measurement of the drug’s lowest concentration in the bloodstream. B. Inject 1% lidocaine prior to each dose: While lidocaine may help reduce discomfort at the injection site, it is not a standard practice for all patients receiving vancomycin and does not address the risk of systemic adverse reactions. C. Give the dose over 60 min: Administering vancomycin over a period of at least 60 minutes is essential to minimize the risk of infusion-related reactions, such as "red man syndrome," which can occur if the drug is infused too quickly. D. Administer the medication undiluted: Vancomycin should always be diluted according to guidelines before administration to reduce the risk of irritation to the veins and potential adverse reactions. Administering undiluted increases the risk of complications.