Question

. Indicate a rational for the answer GİIGU Review-case study The evaluation is designed to assist you in using your critical thinking, clinical reasoning and decision making skills. I. A 45-year-old female patient with a history of diabetes mellitus type 2, hypertension, and obesity is hospitalized for cellulitis in her right foot. Her diabetes and hypertension have previously been well controlled with medication. She is currently receiving vancomycin hydrochloride 1 g IV every 12 hours. 1) Before administering the patient's next dose of vancomycin, what laboratory test should you check? a) Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels b) Vancomycin trough c) Complete blood count (CBC) 2) The next day, the patient develops nausea, vomiting, diarrhea, and a headache. Which laboratory findings alert you to the possibility of acute kidney injury? a) Decreased serum potassium and bicarbonate levels b) Increased white blood cell (WBC) count and erythrocyte sedimentation rate (ESR) c) Increased serum blood urea nitrogen (BUN) and serum creatinine levels 3) The patient is diagnosed with acute kidney injury secondary to vancomycin treatment. Which type of kidney injury listed below would most likely be the result of vancomycin nephrotoxicitv? a) Post-renal cause b) Intrarenal cause c) Prerenal cause 4) Laboratory results on the 5th day of hospitalization show the patient's potassium at a critically high level of 5.8 mEq/L. The patient has hypotension, changes in mental status, and arrhythmias. Based on these findings, which intervention would you expect to perform immediately? a) Administer IV glucose and insulin b) Administer cation-exchange resins, such as sodium polystyrene sulfonate (Kayexalate) c) Prepare the patient for dialysis d) Prepare to administer KCL 10 mEq in 100 mLs normal over 1 hour x 2

Answer 1

Answer 1: (A) Aspartate aminotransferase and alanine aminotransferase level. ( This is because these test level will indicate the affect of the medicine)

Answer 2 : ( C) increased serum blood urea nitrogen and serum creatinine level. ( Due to acute kidney injury, the accumulation of waste materials takes place in the kidney)

Answer 3: (A) Post renal cause ( The drug induced disease)

Answer 4: (C) Prepare the patient for dialysis.