Nursing Teaching on Precautions to be Exercised While Taking Vancomycin

Nurse educated the patient and caregiver on the precautions to be exercised while taking Vancomycin as follows:

  1. Patients with history of antibiotic associated diarrhea must be cautious about using Vancomycin. Discuss with your doctor regarding your history of the same. Report to your doctor regarding any persistent diarrhea, abdominal pain and cramping, and blood or mucus in the stool. These findings could occur even weeks after discontinuation of Vancomycin and must be reported.
  2. Vancomycin carries the risk of causing dizziness and confusion. These responses can significantly increase, if Vancomycin were taken with alcohol. Avoid taking Vancomycin with alcohol. One should stay away from activities, such as, driving and operating heavy machinery, until they are used to the side effects caused by Vancomycin.
  3. Administering the Vancomycin IV medication too fast can result in red man syndrome, characterized by flushing of the body, low blood pressure, and muscle pains. Inflammation at the site of injection with redness and tenderness around the injection site also can occur. Always administer the Vancomycin IV medication only at the recommended rate, to prevent this complication.
  4. Patients with history of diminished hearing and ototoxicity are at increased risk for hearing loss with Vancomycin. Individuals taking Vancomycin must observe a close watch regarding the same and report any changes with hearing to the physician immediately.
  5. Observe compliance with the Vancomycin trough lab ordered, once a week, which helps to determine the dose and the appropriate timing between individual doses of the antibiotic. This helps to assure that the therapeutic concentration of the antibiotic is always maintained in the blood.
  6. Watch closely for development of any opportunistic infections, such as, oral candidiasis with white patches in the mouth, to be reported to the physician.
  7. Check with your doctor regarding safety upon receiving any live vaccinations, as Vancomycin by eliminating natural bacterial flora, could lower the body’s resistance. Live vaccinations could turn virulent in such individuals, precipitating new infections.
  8. Vancomycin is not metabolized and is excreted unchanged in the urine. Individuals with compromised renal functions tend to retain the drug in the circulation longer, thus resulting in toxicity. Vancomycin should be avoided or used with extreme caution in such individuals.
  9. Compliance with blood work ordered to monitor serum potassium and magnesium ions is mandatory, as Vancomycin in individuals with disturbances in serum potassium and magnesium ions can induce life-threatening cardiac arrest.
  10. Evenly space out the doses of the antibiotic and take the dose at the scheduled time every day. Keeping to the schedule helps with maintaining a constant level of the antibiotic in the body, which is needed for infection control. Also, this helps to avoid forgetting the medication.
  11. Maintain strict compliance with intake of Vancomycin as ordered, with regards to dosage and frequency, to derive the benefit of the medication. The dose and length of treatment depends upon the medical condition, severity of infection, and response to treatment.
  12. Complete the course of the antibiotic that it was prescribed for. Do not give up on the antibiotic, against your doctor’s recommendation, even if the symptoms of infection are controlled.
  13. Bile acid Sequestrants or binders, such as, Cholestyramine and Colestipol, can bind Vancomycin too and slow down the absorption of Vancomycin, thereby, reducing the therapeutic effect. Taking the binder by observing a 2 to 3-hour window from the time of Vancomycin intake can help avoid this complication.
  14. Observe compliance with any regular lab work ordered. As Vancomycin carries the risk for damage to the kidneys, renal function could be periodically monitored, to prevent any risk for toxicity. Watch closely to report any symptoms of renal injury and altered kidney function, such as, altered levels of consciousness and reduced urine formation, should be closely watched for and reported to the physician.
  15. Noncompliance with Vancomycin intake for the complete schedule can result in ineffective infection control with chance of relapse of infection with increased vigor. This can also contribute towards emergence of drug resistant strains of bacteria, making infection control more difficult.
  16. Do not change the dose on Vancomycin without consulting your doctor.