What should a nurse monitor before starting antibiotics in clients with liver or kidney failure?

Monitoring liver and kidney function before initiating antibiotic therapy in clients with liver or kidney failure is crucial for several reasons. Both the liver and kidneys are vital organs responsible for drug metabolism and excretion. In individuals with liver impairment, the metabolism of certain antibiotics can be hindered, leading to an increased risk of toxicity or ineffective drug levels. Similarly, renal failure impacts the clearance of medications, which can result in the accumulation of drugs and their metabolites, further increasing the risk of adverse effects.

By assessing liver and kidney function—typically through tests that measure levels of liver enzymes, creatinine, and blood urea nitrogen—a nurse can determine the appropriate choice of antibiotic and dosage adjustments. This ensures that the treatment is both safe and effective, minimizing the likelihood of complications associated with drug toxicity in these vulnerable populations.