Question

Complete the following Case Study

A long-term care facility resident, Ken, had a hip knee replacement 6 months ago and consequently developed an infection with methicillin-resistant Staphylococcus aureus and then osteomyelitis. He has a history of diabetes.

1. Ken receives vancomycin IVPB ordered at 15 mg/kg/day. Ken weighs 220 lb. What daily dose would the nurse administer?

Answer:

Rationale:

2. What nursing considerations are essential when giving this medication?

Answer:

Rationale:

3. What are the signs and symptoms and treatment the nurse would be alert for if Ken developed red man syndrome?

Answer:

Rationale:

Answer 1

1.Weight 220lb (0.454×220=99.88 or 100kg)

If 1kg=15mg

Then 100kg=??

100×15=1500mg

Ans:1500mg/day of medication to be administered

Rationale :A dose more than this can cause adverse reactions and a lesser dose will not be effective

2.The following nursing consideration are to be assesed and done prior to vancomycin administration

• Check for any allergies previously
• Dilute the medication in 100ml normal saline and transfuse for over 60 minutes to prevent and reduce transfusion related reactions
• Assess the patient for any kidney and liver problems
• Hearing loss can happen do prior care and assessment to be made
• Check for any recent live vaccines taken by patient because this drug interact with it

3.Red man syndrome is a severe allergi reaction due to faster transfusions

The nurse should be alert of its symptoms like

• Skin:rash on face ,neck and torso
• Cardiovascular : Chest pain ,low blood pressure level
• Respiratory:Dyspnea
• CNS:Headache
• Other:fever

Treatment :

• Stop transfusion immediately because the reaction may last for up to 20 to few hours
• Administer antihistamine to stop allergic reactions
• Intravenous fluid to increase blood pressure
• Corticosteroids inbcase of difficulty in breathing