What Is the Purpose of Obtaining the Trough Level?
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For this case study please copy and paste questions first then write the answer. Also, please use proper APA, 7th edition format, including links. Must be used at least 3 references or more. This assignment must be summited through SafeAssign. Please do your best, this professor is very particular regarding the references and safeassign. Please use those 2 articles,( the links are provided below) the professor is also particular to use CNO and RNAO articles. Also, please refer to the attached rubric.
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https://www(dot)cno(dot)org/globalassets/docs/prac/41007_medication.pdf
https://rnao(dot)ca/bpg
This is the assignment/ Case Study:
The nurse is preparing a patient care plan for Deshawna, a 20-year-old college student who has been diagnosed with bacterial meningitis. Her symptoms before admission included a significant headache, photophobia, nausea, a stiff neck, and vertigo. A spinal tap was performed, and culture and sensitivity was ordered. While waiting for the results, the physician has ordered gentamicin intravenous piggyback (IVPB) 120 mg every 8 hours. Gentamicin trough levels are ordered every 8 hours, to be taken 30 minutes before administration of the next dose.
1. What is the purpose of obtaining the trough level?
2. What trough level would be considered a normal concentration?
3. What adverse effects of gentamicin will the nurse monitor for in Deshawna?
Case Study
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Case Study
What Is the Purpose of Obtaining the Trough Level?
Therapeutic medication monitoring determines the level of drug in the bloodstream at a specific time. The trough and peak levels are essential data, and nurses have to collect it from patients who receive antibiotics via IV. The trough level is a term that means the lowest amount of medication in the bloodstream of a patient and is measured right before they get the next dosage of the medicine (Hayward et al., 2018). The main goal of getting the trough level is to ensure that the drug is sufficient in the patient’s bloodstream to attain its therapeutic effectiveness. It entails measuring the bloodstream’s medication level before it is administered (trough) and once it has been administered and undergone metabolism (peak). It allows the physician to determine the patient’s tolerance level, applicable frequency, and drug dose (Hayward et al., 2018). The patient’s tolerance is also determined using other tests like liver function, blood count, electrolytes, and creatinine panel.
If the trough level is too low, then this would mean that the patient does not gain from using the medication. The information can allow the physician to respond by adjusting the dose, such as increasing the dosage to get to the appropriate level, modifying the time between dosages, or combining the two strategies. If the level is high, then this signifies that the patient has problems metabolizing the drug. Administering the dose too soon can negatively affect the patient if the medication levels reach a toxic level, which results in organ damage. Nurses have to determine the peak level within 30 minutes after administering the dose (Registered Nurses’ Association of Ontario, 2020). It ensures that the drug’s concentration at a peak level is enough to treat the condition but not very high that it becomes poisonous.
What Trough Level Would Be Considered A Normal Concentration?
Based on the case scenario, a normal concentration of the gentamicin trough level is <2mg/ L while an optimum level is <1mg/L. The normal concertation ranges between 0.5-2 µg/mL (Antolik et al., 2017). Additionally, a toxic concentra...