A nurse is caring for a client who is receiving gentamicin, an aminoglycoside antibiotic, for a severe infection.
The nurse should monitor the client for which adverse effects of this drug? (Select all that apply.)

Inappropriate antibiotic use leads to the emergence of resistance.This is a well-established fact that is supported by the CDC and other organizations.Resistance can occur when antibiotics are used unnecessarily, excessively, or incorrectly, and can lead to infections that are harder to treat and more costly.

Choice A is wrong because antibiotic guidelines in critical care do not necessarily reduce the hospital length of stay.Although some studies have suggested that adherence to pneumonia guidelines may improve outcomes in severe pneumonia, other studies have found no significant effect of antibiotic stewardship on hospital length of stay or mortality in critically ill patients.

Therefore, this statement is not universally true.

Choice C is wrong because antibiotic dosing has a significant effect on antimicrobial resistance.Optimal dosing of antibiotics can help eradicate infections, prevent relapse, and minimize the selection of resistant bacteria.Conversely, suboptimal dosing can lead to treatment failure, prolonged infection, and increased resistance.

Therefore, antibiotic dosing should be carefully adjusted according to the pharmacokinetic and pharmacodynamic properties of the drug and the patient.

Choice D is wrong because an antibiotic stewardship programme leads to a decrease in antimicrobial resistance, not an increase.An antibiotic stewardship programme is a coordinated effort to improve and measure the appropriate use of antibiotics by promoting the selection of the optimal drug regimen, dose, duration, and route of administration.Such programmes have been shown to reduce antibiotic consumption, resistance rates, adverse events, and costs in various settings.

Therefore, this statement is false.

Maraviroc is aCCR5 coreceptor antagonistthat blocks the receptor site the HIV virus needs to interact with in order to enter the cell.It prevents viral fusion with host cell membrane by binding to the CCR5 receptor on CD4+ T cells and macrophages.

Choice B is wrong becauseAbacavir is wrong because it is anucleoside reverse transcriptase inhibitor (NRTI)that inhibits the enzyme reverse transcriptase, which converts viral RNA into DNA.

It does not prevent viral fusion with host cell membrane.

Choice C is wrong becauseDarunavir is wrong because it is aprotease inhibitor (PI)that inhibits the enzyme protease, which cleaves viral proteins into functional units.

It does not prevent viral fusion with host cell membrane.

Choice D is wrong becauseFosamprenavir is wrong because it is also aprotease inhibitor (PI)that inhibits the enzyme protease.

It does not prevent viral fusion with host cell membrane.