A nurse is reviewing a client's peak and trough levels of gentamicin. The peak should be 6 to 8 mcg/mL and the trough should be 0.5 to 1 mcg/mL. The client's peak is10 mcg/mL and his trough is 2.3 mcg/mL. Which of the following clinical manifestations should the nurse expect with these findings? (Select all that apply.)

B. Sucralfate should be taken on an empty stomach, at least 1 hour before meals or 2 hours after meals, to maximize its effectiveness. Food can interfere with its ability to coat the stomach lining.

A. Constipation is a common side effect of sucralfate, but it does not typically require discontinuation of the medication. Instead, clients are often advised to manage constipation with dietary fiber, fluids, and sometimes mild laxatives if necessary.

C. Antacids can interfere with sucralfate by altering its pH-dependent activation and should not be taken simultaneously. If antacids are necessary for symptom relief, they should be taken at least 30 minutes before or after sucralfate.

D. There is no specific instruction to remain upright after taking sucralfate

A. Infiltration occurs when IV fluid or medication leaks into the surrounding tissues rather than entering the vein. Coolness, blanching (pale appearance), swelling, and discomfort at the IV site are common signs of infiltration.

B. Local inflammation at the IV site can occur due to irritation or infection. Redness, warmth, swelling, tenderness, and possibly purulent drainage (pus) are typical signs. The description of a cool and blanched IV site does not fit the typical signs of inflammation, which usually involve warmth and redness.

C. Thrombophlebitis is inflammation of a vein with associated blood clot formation. Pain, warmth, redness, and swelling along the path of the vein are common. Thrombophlebitis typically presents with warmth and redness at the site, whereas the cool and blanched appearance described by the student suggests fluid infiltration rather than a thrombus causing inflammation.

D. Phlebitis is inflammation of the vein itself. Pain, redness, warmth, and swelling directly over the vein. Phlebitis usually manifests with warmth and redness, which are not present in the described symptoms.