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.)

A. Pantoprazole belongs to a class of medications called proton pump inhibitors (PPIs), which work by reducing the production of gastric acid in the stomach. This helps in treating conditions such as gastroesophageal reflux disease (GERD) and heartburn effectively.

B. Pantoprazole is not known to cause hyperkalemia. Hyperkalemia is a condition characterized by high levels of potassium in the blood, and it is typically associated with certain medications (e.g., potassium- sparing diuretics) or medical conditions affecting kidney function. Pantoprazole's primary side effects relate to its effects on gastric acid production and absorption of certain nutrients.

C. While pantoprazole is usually taken once daily, the timing of administration is typically in the morning, before a meal. This helps to maximize its effectiveness in reducing gastric acid secretion when the stomach acid production is at its highest.

D. Pantoprazole should be taken on an empty stomach, at least 30 minutes before a meal. This timing allows the medication to be absorbed properly and work effectively to reduce gastric acid production.

C. This method is recommended because it is less painful, as the sides of the fingertips have fewer nerve endings compared to the pads or 'balls' of the fingers.

A. Avoiding the use of the thumbs is not necessary unless they are calloused or used frequently for other tasks that could affect sensitivity.

B. Avoiding the use of the dominant hand's fingers are not necessary unless they are calloused or used frequently for other tasks that could affect sensitivity.

D. Using the ball of the finger is not recommended for blood glucose monitoring because it can be more painful and may lead to less blood flow, resulting in difficulty obtaining an adequate blood sample.