Peak Levels of Vancomycin

[edge24bri]

Hi, everyone....new poster, long time reader.

I am a 57yr old studying for my NCLEX, imagine that? I feel like I know absolutely nothing. I have an LPN which acquired in 2012, however, I have lost some brain cells since then. HAHA.

Bare with me please.

I run across numerous conflicting information regarding when to draw peak levels of Vancomycin. A nursing review I took said 30 minutes after the completion of infusion. Some books say the same, google searches such as Med Scape says 1 to 2 hours after, which makes sense in that the duration is 12- 24 hours. Kaplan says 5 minutes, my job does it 1 to 2 hours after completion (lab always asks what time it was drawn).

So yea, I'm pulling my hair out.

I need to now what NCLEX expects from so many conflicting information. I know there is the NCLEX world where nurses have 1 patient and everything is hunky dory and then there is the real world, and please do not say that nurses cut corners, because my nurses don't....maybe they run a little late (not much) with their charting but, they don't cut corners.

Please someone what does peak time does NCLEX want, 30 mins or 1-2 hours?

Help!

Signed,

Eileen who is Frazzled

[Momma1RN, MSN, RN, APRN]

I would probably go by what a drug guide says. I honestly wouldn't get hung up over this sort of thing for NCLEX. It's not that specific. Keep your knowledge base broad and know big concepts. Don't overthink. Breathe. And you should do fine. Good luck!

[Littleguccipiggy]

Don't worry, the NCLEX won't ask something that insanely specific. They mostly just test you on what you should know to keep the patient safe (I had a question that asked me what order I don my PPE). I can't even remember the last time I drew a vanco through, my biggest resource is the pharmacist for that kind of question.

[IVRUS, BSN, RN]

And please know too that Vancomycin Peaks are rarely done any longer. Troughs are what most ID docs are concerned about. What is that level in the body when it's at its lowest? And troughs have changed considerably over the past couple of years. Normal trough used to be 5-10. Now it can be as high as 25, and still not be considered toxic.

As far as peaks are concerned, you may still see some older docs ordering it, and ideally it should be performed 1.5 hours post completion of the Vanc. (remember to draw your creatinine too along with the trough.)