medium · NCLEX-RN Safety and Infection Prevention and Control
A 61-year-old female with a history of recurrent urinary tract infections and stool colonization with vancomycin-resistant Enterococcus (VRE) is admitted with a temperature of 39.1 C (102.4 F), heart rate of 112/min, and blood pressure of 96/60 mm Hg. Blood and urine cultures are drawn. The provider orders empiric IV vancomycin 1,000 mg every 12 hours.
Which action should the nurse take first?
- Wait for the blood culture results to show active resistance before questioning the antibiotic choice, for this client, based on the information currently available.
- Administer the vancomycin as ordered to rapidly treat the suspected Gram-negative sepsis.
- Administer the vancomycin but request that the blood cultures be processed faster to identify the organism, in this situation, for the clinical situation described.
- Contact the provider to question the vancomycin order and suggest an agent with VRE coverage, such as linezolid or daptomycin, given the high risk of VRE bacteremia.
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