For a drug with a narrow therapeutic index, what is a critical nursing consideration?

For a drug with a narrow therapeutic index, what is a critical nursing consideration?

• A. Administering only at night
• B. Ignoring lab values
• C. Giving high doses first
• D. Close monitoring and therapeutic drug monitoring for toxicity

Answer: (D)

Drugs with a narrow therapeutic index carry a small margin between relief of symptoms and toxicity, so the key nursing action is close monitoring of drug levels and patient response. This means using therapeutic drug monitoring to measure concentrations and keep them within the safe therapeutic window, along with regular lab checks (such as kidney and liver function) and assessment for early signs of adverse effects. Based on those data, dosing can be adjusted to maintain efficacy while avoiding toxicity. Other approaches don’t address this safety need—simply giving the drug at night doesn’t control levels, ignoring lab values misses critical information about how the drug is being processed in the body, and giving high initial doses risks pushing the level into toxicity before monitoring can guide adjustments.

Drugs with a narrow therapeutic index carry a small margin between relief of symptoms and toxicity, so the key nursing action is close monitoring of drug levels and patient response. This means using therapeutic drug monitoring to measure concentrations and keep them within the safe therapeutic window, along with regular lab checks (such as kidney and liver function) and assessment for early signs of adverse effects. Based on those data, dosing can be adjusted to maintain efficacy while avoiding toxicity.

Other approaches don’t address this safety need—simply giving the drug at night doesn’t control levels, ignoring lab values misses critical information about how the drug is being processed in the body, and giving high initial doses risks pushing the level into toxicity before monitoring can guide adjustments.