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. Before administering any medication, especially antibiotics like amoxicillin, the nurse must assess the patient for allergies or previous adverse reactions to amoxicillin or other beta-lactam antibiotics. Allergic reactions can range from mild rashes to severe anaphylactic reactions, so it's essential to confirm the

patient's allergy status and assess for any signs or symptoms of allergic reaction before proceeding with administration.

A. Flushing the IV site with normal saline is typically not required specifically before administering IV amoxicillin unless it is part of the institution's standard practice to flush all IV lines before and after medication administration.

C. While monitoring intake and output (I&O) is important for assessing fluid balance and kidney function, it is not directly necessary before administering IV amoxicillin unless there are specific concerns related to the patient's fluid status or renal function. However, it is good practice to have a general understanding of the patient's recent fluid intake and output patterns.

D. Creatinine clearance is a measure of kidney function. Checking the latest creatinine clearance result is important for assessing renal function, especially before administering medications excreted by the kidneys. However, amoxicillin is primarily excreted by the kidneys in its unchanged form, so knowing the patient's renal function status can help in determining the appropriate dosage or adjusting the dosing interval if necessary.

D. Muscle weakness is a hallmark sign of hypokalemia. Potassium is crucial for proper muscle contraction, and low levels can impair muscle function. This weakness can affect skeletal muscles (resulting in fatigue, cramps, or generalized weakness) as well as smooth muscles (contributing to constipation or other gastrointestinal symptoms).

A. Hypokalemia is not typically associated with hyperactive bowel sounds.

B. Cerebral edema is not typically associated with hypokalemia. Instead, cerebral edema can occur with conditions such as hyponatremia (low sodium levels) or other metabolic disturbances.

C. Hypokalemia is more commonly associated with hypotension (low blood pressure) rather than hypertension. Low potassium levels can affect vascular smooth muscle tone, potentially leading to vasodilation and hypotension.