A nurse is caring for a 55-year-old client who requires antibiotic therapy.

Exhibits

A nurse is reviewing a client's medical record. Select the 4 findings that place the client at risk for hearing impairment.

Osteoarthritis

Place of employment

Gentamycin

Naproxen

Bumetanide

Heart failure

Answer and Explanation

Correct Answer : B,C,D,E

A.   Osteoarthritis is not associated with hearing loss
B.   The client's place of employment as a firearms instructor at a shooting range exposes them to loud noises, which is a well-known risk factor for hearing loss.
C.   Gentamycin is an aminoglycoside antibiotic that can be ototoxic, especially when administered in high doses or for prolonged periods, potentially leading to hearing loss.
D.   Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that has been associated with an increased risk of hearing loss, particularly when taken regularly or in high doses.
E.   Bumetanide is a loop diuretic that can also have ototoxic effects, especially when used in conjunction with aminoglycoside antibiotics like gentamycin.
F.   Heart failure is not associated with hearing loss

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Correct Answer is ["A","B","D"]

Explanation

A. The fingerstick blood glucose level of 55 mg/dL at 1130 indicates hypoglycemia, which requires immediate attention to prevent further complications such as loss of consciousness or severe symptoms.
B. The client's report of shakiness, hunger, and cool, diaphoretic skin are signs of hypoglycemia, especially given the low blood glucose level. This requires prompt intervention to manage the blood glucose level.
C. The temperature of 37.8 °C (100 °F) is slightly elevated but does not require immediate follow-up unless there are other symptoms of infection or significant changes.
D. The elevated heart rate of 118/min could indicate an underlying issue such as dehydration, hypoglycemia, or infection. It requires further evaluation in the context of other findings.
E. The SpO2 of 95% on room air is within an acceptable range and does not require immediate follow-up unless there are other signs of respiratory distress or worsening condition.
F. The HbA1c of 8.01% reflects long-term glucose control but is not an immediate concern for follow-up in the acute setting. It is important for overall management but not an urgent issue for this particular scenario.

A. "Tremors, nervousness, and insomnia may indicate your dose is too high." B. "Notify your healthcare provider if you begin to lose weight." C. "This medication will require monitoring for increased risk for bleeding." D. "The medication decreases the overproduction of the thyroid hormone thyroxine."

Correct Answer is A

Explanation

A. Levothyroxine is a thyroid hormone replacement used to treat hypothyroidism. Symptoms such as tremors, nervousness, and insomnia can indicate that the dose is too high, as these are signs of hyperthyroidism.
B. Weight loss is not a typical reason to notify the healthcare provider unless it is accompanied by other symptoms of hyperthyroidism. Monitoring for symptoms of excessive thyroid hormone can be more critical.
C. Levothyroxine does not typically require monitoring for an increased risk of bleeding. This medication primarily affects thyroid hormone levels and does not have a direct impact on blood clotting.
D. Levothyroxine increases, rather than decreases, thyroid hormone levels. It is used to replace or supplement thyroid hormone in the case of hypothyroidism, not to decrease thyroid hormone production.

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A nurse is caring for a 55-year-old client who requires antibiotic therapy. Exhibits A nurse is reviewing a client's medical record. Select the 4 findings that place the client at risk for hearing impairment.

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A nurse is caring for a 55-year-old client who requires antibiotic therapy.

Exhibits

A nurse is reviewing a client's medical record. Select the 4 findings that place the client at risk for hearing impairment.