Question

senario-

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?

Answer 1

1. Trough level is the lowest level of drug present in patient's blood and the specimen to check trough level must be collected prior to drug administration. Trough and peak levels of drugs are tested to identify the appropriate dosage levels of particular drugs. Peak level is the highest concentration of drug in patient's blood.
2. Gentamycin trough level of <1mg/L is the optimum level and <2mg/ L is acceptable. Normal range is between 0.5 to 2 mg/L
3. Nurse must monitor for the following potential side effects of gentamycin administration which are Vertigo, dizziness, electrolyte imbalance, elevation in serum bilirubin levels, convulsions, hallucinations, purpura, nausea and vomiting. Other fatal reactions includes ototoxicity, nephrotoxicity and neuromuscular blockade. Ototoxicity and nephrotoxicity are common fatal adverse reactions.