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    Hesi rn pharmacology proctored exam

    The nurse is administering IV fluconazole to a client who has systemic candidiasis. After reviewing the client's di’gnostic studies, the nurse identifies a rising trend in the liver enzyme levels for aspartate aminotransferase (AST). Which action should the nurse implement?

    Explanation & Rationale

    A) Hold the dose and notify the pharmacy to stop dispensing the next premixed doses: This action may prevent further administration of fluconazole, but it does not address the underlying concern of rising liver enzyme levels. Holding the dose and notifying the healthcare provider directly would be more appropriate. B) Hold the dose and notify the healthcare provider of the changes in the laboratory studies: This is the correct response. RisIng liver enzyme levels, indIcated by an increasing trend in aspartate aminotransferase (AST), suggest potential liver dysfunction or damage, which can be a serious adverse effect of fluconazole. The nurse should hold the dose and promptly inform the healthcare provider for further evaluation and management. C) Begin the infusion and monitor the client's bl’od urea nitrogen (BUN), serum creatinine, and liver function tests: Initiating the infusion without addressing the rising liver enzyme levels could potentially worsen liver function. It is essential to hold the dose and inform the healthcare provider before proceeding with further administration. D) Begin the infusion and submit a drug reaction report to the nursing supervisor: While it's im’ortant to document adverse reactions and submit reports as appropriate, the priority in this situation is to hold the dose and notify the healthcare provider to address the rising liver enzyme levels.

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