A nurse is providing teaching for a client who has a prescription for gentamicin. Which of the following should the nurse include as an adverse effect of this medication?

Furosemide is a loop diuretic commonly used to treat fluid volume excess by promoting diuresis. One of the expected outcomes of furosemide administration is an increased urinary output as excess fluid is eliminated from the body. Therefore, if the medication has been effective, the nurse would expect to see an increased urinary output as a result of the diuretic effect.

Increased respiratory rate (B) is not an expected outcome of furosemide administration. It may occur in some cases due to increased fluid elimination and potential electrolyte imbalances, but it is not the primary indicator of the medication's effectiveness.

Decreased blood pressure (C) is a possible outcome of furosemide administration due to the diuretic effect and subsequent reduction in fluid volume. However, it is not the most specific indicator of the medication's effectiveness in this case.

Increased pulse (D) is not a typical finding associated with the effectiveness of furosemide. In fact, furosemide can sometimes cause a decrease in heart rate due to its impact on fluid and electrolyte balance.

The nurse should report to the provider that the client is taking ginkgo biloba. Ginkgo biloba is an herbal supplement that can interact with clopidogrel and other antiplatelet medications. It may increase the risk of bleeding when taken concurrently with clopidogrel, which is an antiplatelet medication used to prevent blood clots after coronary artery stenting.

Let's go through the other options:

A. The client is taking acetaminophen: Acetaminophen is not known to have significant interactions with clopidogrel. It is a commonly used pain reliever and fever reducer and does not usually affect the antiplatelet activity of clopidogrel.

B. The client is taking valerian: Valerian is an herbal supplement often used as a sleep aid or to reduce anxiety. While there is limited evidence of significant interactions with clopidogrel, it is generally recommended to use caution when combining valerian with antiplatelet medications. However, it is not as concerning as ginkgo biloba in terms of potential bleeding risk.

C. The client is taking vitamin B6: Vitamin B6 is a water-soluble vitamin and is not expected to have significant interactions with clopidogrel. It is generally considered safe to use vitamin B6 with antiplatelet medications like clopidogrel.