The client has an order for a trough to be drawn on the client receiving Vancomycin. The nurse is aware that the nurse should contact the lab for them to collect the blood:
A. 15 minutes after the infusion
B. 30 minutes before the infusion
C. 1 hour after the infusion
D. 2 hours after the infusion
Correct Answer: B. 30 minutes before the infusion
A trough level should be drawn 30 minutes before the third or fourth dose. Draw trough specimens immediately before (?30 min) the next dose. Do not draw specimens until a steady state is achieved (ie, before the fourth dose). Draw peak specimens 1-2 hours after completion of intravenous dosage.
Option A: Vancomycin is a glycopeptide antibiotic first isolated in 1953. It is a naturally occurring antimicrobial synthesized by soil bacterium Amycolatopsis Orientalis. Generic vancomycin became available and approved for use in 1958 and quickly became a common antibiotic in treating rapidly growing penicillin-resistant Staphylococcus species.
Option C: The emergence of pseudomembranous enterocolitis, coupled with the spread of methicillin-resistant Staphylococcus aureus (MRSA), led to a resurgence in the use of vancomycin. It is used to treat serious, life-threatening infections by gram-positive bacteria that are resistant to less-toxic agents.
Option D: General indications for measuring vancomycin trough levels include risk of nephrotoxicity and inadequate therapeutic response. Monitor at regular intervals. Specifically, trough levels should be measured in patients at risk for nephrotoxicity.