A nurse at an ophthalmology clinic Is providing teaching to a client who has open-angle glaucoma and a new treatment regimen of timolol and pilocarpine eye drops. Which of the following instructions should the nurse provide?

The correct answer is choiceb. Monitor the serum medication levels.

Choice A rationale:

Administering gentamicin with food is not necessary and does not minimize the risk of adverse effects. Gentamicin is typically given intravenously or intramuscularly, and food does not impact its administration or absorption.

Choice B rationale:

Monitoring the serum medication levels is crucial when administering gentamicin. Gentamicin has a narrow therapeutic index, meaning the difference between a therapeutic dose and a toxic dose is small. Regular monitoring helps ensure the drug remains within the safe and effective range, reducing the risk of nephrotoxicity and ototoxicity.

Choice C rationale:

Limiting the client’s fluid intake is not recommended. Adequate hydration is important to help prevent nephrotoxicity, a known adverse effect of gentamicin. Ensuring the client has sufficient fluid intake can help protect kidney function.

Choice D rationale:

Instructing the client to report agitation is not directly related to minimizing the risk of adverse effects of gentamicin. While it is important for clients to report any unusual symptoms, agitation is not a common adverse effect of gentamicin. Monitoring for signs of nephrotoxicity (e.g., decreased urine output) and ototoxicity (e.g., hearing loss, tinnitus) is more relevant.

Cyclosporine is an immunosuppressant medication that is often used following organ transplant to prevent rejection. Grapefruit juice can increase the absorption of cyclosporine, leading to an increased risk of side effects and toxicity. Therefore, clients taking cyclosporine should be advised to avoid grapefruit and grapefruit juice while taking this medication. Pepperoni and smoked salmon do not have any known interactions with cyclosporine. Orange juice may also interact with cyclosporine, but not to the same extent as grapefruit juice. It is generally recommended that clients taking cyclosporine avoid drinking large amounts of orange juice and to inform their healthcare provider if they experience any adverse effects.