QLexNursing

Blood urea nitrogen 17 mg/dL (within normal limits)

💎 Vancomycin is renally cleared; safe administration depends on adequate renal function to avoid drug accumulation and nephrotoxicity.

💎 A BUN of 17 mg/dL falls within the normal range (≈8–20 mg/dL), supporting appropriate clearance.

💎 The client’s creatinine 0.82 mg/dL further corroborates preserved kidney function, lowering immediate risk for toxicity.

💎 With normal renal indices, no pre‑dose renal adjustment is required (continue to monitor levels per protocol if therapy continues).

💎 Stable renal labs help prevent AKI and supratherapeutic exposure during prophylaxis.

Dosage in safe range

💎 Vancomycin 1 g IV is a commonly used adult prophylactic dose and aligns with many perioperative protocols when weight‑based calculations are not mandated.

💎 The ordered infusion 250 mL at 125 mL/hr ≈ 120 min, which is slower than the minimum 60‑minute requirement for 1 g, helping prevent infusion reactions (e.g., red man syndrome).

💎 The effective, guideline‑concordant dose and rate support antibacterial coverage while minimizing adverse effects.

💎 Dose safety always pairs with clinical monitoring (vitals, infusion site, signs of reaction).

💎 Appropriate dosing and rate together optimize efficacy and tolerability.

No known allergies

💎 Absence of documented drug allergy significantly reduces immediate risk for IgE‑mediated anaphylaxis or severe hypersensitivity to vancomycin.

💎 Screening for prior reactions to glycopeptides (e.g., vancomycin) is a critical safety step before first-dose administration.

💎 Even without allergies, the nurse should monitor closely for infusion‑related reactions (flushing, pruritus, hypotension).

💎 Clear allergy status enables timely prophylaxis without delay for alternative agents.

💎 Maintaining an updated allergy record is essential for safe antimicrobial stewardship.

Peripheral IV (PIV) in large vein

💎 Vancomycin is an irritant and can cause phlebitis if infused through small or fragile veins.

💎 A 20‑gauge PIV in the antecubital fossa qualifies as a large, high‑flow peripheral vein, lowering local infusion complications.

💎 Proper vein selection helps preserve line patency and ensures the ordered infusion rate can be safely maintained.

💎 Good vascular access reduces infiltration/extravasation risk and improves patient comfort.

💎 Optimal line choice is a core safety measure for vesicant/irritant antimicrobials.