A nurse is collecting data from a client who has pyelonephritis and receiving gentamicin via IV infusion. Which of the following manifestation should the nurse identify as an adverse effect of the treatment?

Slurred speech

Constipation

Hypotension

New onset of hearing loss

Answer and Explanation

The Correct Answer is D

A) Slurred speech:
Slurred speech is not a common adverse effect of gentamicin. It could indicate neurological issues, but it is not typically associated with gentamicin use. If this occurs, the nurse should investigate other possible causes, such as a stroke or another neurological condition, rather than attributing it to the gentamicin.

B) Constipation:
Constipation is not a typical adverse effect of gentamicin. While antibiotics can sometimes cause gastrointestinal disturbances, gentamicin is more commonly associated with nephrotoxicity and ototoxicity, rather than constipation. If constipation occurs, it is more likely related to other factors such as diet or fluid intake.

C) Hypotension:
While hypotension can be a side effect of many medications, it is not a specific or common adverse effect of gentamicin. Gentamicin is more likely to cause nephrotoxicity and ototoxicity rather than significant blood pressure changes. However, hypotension could occur in the context of an infection or severe illness and should be monitored, but it is not directly associated with gentamicin.

D) New onset of hearing loss:
This is a well-known adverse effect of gentamicin. Gentamicin belongs to the class of antibiotics known as aminoglycosides, which can cause ototoxicity. New onset of hearing loss or tinnitus (ringing in the ears) is a significant warning sign of ototoxicity, which can occur due to gentamicin use. This side effect should be monitored closely, and if hearing loss occurs, the medication should be reevaluated, and alternatives should be considered.

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Correct Answer is A

Explanation

A) Hot cocoa: Hot cocoa contains the least amount of caffeine compared to the other beverages listed. While it does contain some caffeine, it is significantly lower than coffee, tea, or cola. A typical 8 oz serving of hot cocoa contains approximately 3-10 mg of caffeine, making it the best option for a client looking to reduce caffeine intake.

B) Brewed green tea: Brewed green tea contains more caffeine than hot cocoa. On average, an 8 oz cup of brewed green tea contains about 25-30 mg of caffeine, which is more than cocoa but less than coffee or cola. Although green tea has health benefits, it may not be the best option for those trying to limit caffeine intake.

C) Instant coffee: Instant coffee typically contains more caffeine than brewed green tea or hot cocoa. An 8 oz serving of instant coffee can contain around 30-90 mg of caffeine, depending on the brand and how it is prepared. While it provides a caffeine boost, it is not a good choice for someone seeking to reduce caffeine consumption.

D) Cola soft drink: Cola soft drinks contain a moderate amount of caffeine, usually about 30 mg per 8 oz serving. While this is less than coffee or tea, it still contains more caffeine than hot cocoa and could be a concern for someone trying to cut back on caffeine.

A. Beefy, red tongue B. Paroxysmal cough C. Peeling of the hands and feet D. Fever

Correct Answer is D

Explanation

A) Beefy, red tongue: The beefy, red tongue is typically associated with scarlet fever, a bacterial infection caused by group A Streptococcus. This condition can lead to a red, "strawberry" tongue, often accompanied by a rash. While measles can involve a variety of symptoms, including a red rash, conjunctivitis, and cough, the beefy red tongue is not characteristic of measles. In measles, the more notable symptoms are a high fever, cough, runny nose, and the development of Koplik spots inside the mouth.

B) Paroxysmal cough: Paroxysmal cough, which is a sudden, severe, and uncontrollable cough often followed by a "whooping" sound, is more characteristic of pertussis (whooping cough). While a cough is indeed present with measles, it is generally not paroxysmal. In measles, the cough is more persistent and associated with other typical symptoms such as fever and a characteristic rash. The coughing in measles may also be dry and harsh but does not tend to occur in violent, paroxysmal episodes like those seen in pertussis.

C) Peeling of the hands and feet: Peeling of the skin, particularly of the hands and feet, is more commonly observed in conditions such as scarlet fever, Kawasaki disease, or after a viral infection like hand-foot-and-mouth disease. It is not a classic finding of measles. In measles, the skin rash usually starts as maculopapular spots on the face and spreads down the body. While some skin sloughing can occur after the rash resolves, especially in severe cases, it is not the characteristic sign of measles, and it is not typically seen on the hands and feet.

D) Fever: Fever is one of the earliest and most prominent symptoms of measles. It typically appears about 2-4 days before the characteristic measles rash. The fever in measles can be quite high, often exceeding 104°F (40°C), and is associated with other symptoms such as cough, conjunctivitis, and photophobia. The fever usually persists for several days, and it is one of the critical signs that lead to the diagnosis of measles, particularly when combined with the characteristic rash and other respiratory symptoms.

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A nurse is collecting data from a client who has pyelonephritis and receiving gentamicin via IV infusion. Which of the following manifestation should the nurse identify as an adverse effect of the treatment?

Nursing Test Bank

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