A nurse is caring for a client who has an infection and a prescription for gentamicin Intermittent IV bolus every 8 hr. A peak and trough are required with the next dose. Which of the following actions should the nurse take to obtain an accurate gentamicin serum level?

A.Cephalexin oral suspension should typically be stored in the refrigerator to maintain its stability and effectiveness. Storing it at room temperature could affect its potency.

B.Shaking the oral suspension is necessary to ensure the medication is evenly distributed before each dose, providing the client with the correct dosage of active ingredients. Failure to shake the suspension can result in uneven dosing.

C.Cephalexin is a cephalosporin antibiotic, and there is a potential for cross-sensitivity in clients who are allergic to penicillin. Up to 10% of people with a penicillin allergy may also be allergic to cephalosporins. Checking for a penicillin allergy helps prevent an adverse reaction, making it a critical safety measure before administering cephalexin.

D.While some antibiotics can cause gastrointestinal side effects, constipation is not a common adverse effect associated with cephalexin. The nurse should instead monitor for other side effects like diarrhea, which is more typical with antibiotics and can indicate a mild side effect or a more severe condition, such as Clostridioides difficile infection.

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.