A client with bleeding esophageal varices receives vasopressin intravenously (IV). Which adverse effect should the nurse monitor for during the IV infusion of this medication?

Choice A rationale:

The nurse should consider the patient's physical abilities and limitations when planning recreational activities because this information is crucial for ensuring the safety and appropriateness of the activities. For example, a patient with limited mobility may benefit from activities that can be done in a seated position, while a patient with greater physical abilities may be able to engage in more active pursuits.

Choice B rationale:

The patient's cognitive abilities and limitations should also be taken into account when planning activities. Some patients may have cognitive impairments that require simpler, more straightforward activities, while others may be able to participate in more complex or intellectually stimulating options. This ensures that the activities are enjoyable and suitable for the individual's cognitive capacity.

Choice C rationale:

Considering the patient's interests and preferences is essential to make the recreational activities meaningful and enjoyable. It is important to involve patients in activities they find interesting and pleasurable, as this can have a positive impact on their emotional and psychological well-being during the rehabilitation process.

Choice E rationale:

The patient's cultural and religious background is an important consideration when planning activities. Some activities may be more or less acceptable to individuals from different cultural or religious backgrounds. It's essential to respect cultural and religious preferences to ensure that the activities do not cause discomfort or offense to the patients.

Choice D rationale:

The patient's age and gender are not the primary factors to consider when selecting appropriate activities for individuals in a rehabilitation and restorative care setting. Age and gender do not necessarily determine a person's interests, physical abilities, or cognitive limitations. Therefore, they are not as relevant as the other factors listed in this context.

This is the correct answer because it is the best way to assess for signs of ototoxicity, which is a potential adverse effect of aminoglycosides. Ototoxicity is the damage or injury to the inner ear or auditory nerve caused by certain drugs or chemicals. It can result in hearing loss, tinnitus, vertigo, or balance problems. Aminoglycosides are a class of antibiotics that are effective against gram-negative bacteria, but they can also cause ototoxicity by interfering with the function of the hair cells in the cochlea. The practical nurse (PN) should monitor the client's hearing by asking about any changes in hearing acuity, ringing in the ears, or difficulty understanding speech. The PN should also perform a hearing test using a tuning fork or an audiometer if available. The PN should report any signs of ototoxicity to the health care provider and discontinue the aminoglycoside as ordered.

a) Check for changes in vision.

This is not the correct answer because it is not related to ototoxicity. Vision is the ability to see and perceive objects and colors using the eyes and the brain. Vision may be affected by various factors, such as age, genetics, eye diseases, injuries, infections, or medications. However, aminoglycosides do not cause vision problems or impairments. The PN should check for changes in vision in a client who is receiving other drugs that can cause ocular toxicity, such as ethambutol, chloroquine, or digoxin.

c) Observe the skin for a rash.

This is not the correct answer because it is not related to ototoxicity. A rash is a change in the color, texture, or appearance of the skin that may be caused by various factors, such as allergies, infections, inflammation, or medications. A rash may present as redness, itching, swelling, blisters, bumps, or scales.
Aminoglycosides can cause skin reactions such as rash or urticaria in some clients who are hypersensitive or allergic to them. The PN should observe the skin for a rash in a client who is receiving an aminoglycoside and report any signs of an allergic reaction to the health care provider. However, a rash is not a sign of ototoxicity.

d) Measure the urinary output.

This is not the correct answer because it is not related to ototoxicity. Urinary output is the amount of urine produced and excreted by the kidneys and bladder. It is an indicator of renal function and fluid balance. The normal range for urinary output is 0.5 to 1 mL/kg/hour for adults. Urinary output may be affected by various factors, such as fluid intake, dehydration, diuretics, kidney disease, or medications. Aminoglycosides can cause nephrotoxicity, which is another potential adverse effect of these drugs. Nephrotoxicity is the damage or injury to the kidneys caused by certain drugs or chemicals. It can impair the kidneys' ability to filter waste products from the blood, resulting in reduced urine production and oliguria. The PN should measure the urinary output in a client who is receiving an aminoglycoside and report any signs of nephrotoxicity to the health care provider. However, urinary output is not a sign of ototoxicity