A nurse is reviewing the medical record of a client who is taking epoetin alfa. Which of the following laboratory tests should the nurse monitor to determine the effectiveness of the medication? (Select all that apply.)

The nurse should include tinnitus (ringing in the ears) as an adverse effect of gentamicin in the client's teaching. Gentamicin is an aminoglycoside antibiotic commonly used to treat bacterial infections. One of the potential side effects of gentamicin is damage to the inner ear, which can lead to tinnitus.

Tinnitus is a concerning symptom as it may indicate ototoxicity, which is damage to the structures of the inner ear responsible for hearing and balance. If the client experiences tinnitus while taking gentamicin, it is essential to notify the healthcare provider immediately to assess the severity of the issue and consider appropriate interventions.

Let's go through the other options and explain why they are not adverse effects of gentamicin:

A. Urinary frequency: Urinary frequency is not a common adverse effect of gentamicin. Gentamicin primarily affects the kidneys, and its main concern is related to potential nephrotoxicity (kidney damage) rather than causing urinary frequency.

B. Constipation: Constipation is not an adverse effect typically associated with gentamicin. Gentamicin is not known to affect the gastrointestinal system or cause constipation.

C. Hypertension: Hypertension (high blood pressure) is not a known adverse effect of gentamicin. Gentamicin primarily affects the kidneys and the inner ear, as mentioned earlier, but it does not significantly impact blood pressure.

The nurse should plan to take the following actions:

A.Verify the prescription: Before administering any medication, the nurse must verify the prescription to ensure accuracy, appropriateness, and that it matches the provider's order.

Regarding option B, administering the medication at 1000, 1400, 1800, and 2200 may not be appropriate. The prescription states that ampicillin should be administered every 6 hours. The nurse should administer the medication at equally spaced intervals throughout the day. If the medication is prescribed every 6 hours, the appropriate administration times would be 0600, 1200, 1800, and 2400. However, the question does not provide sufficient information to determine the exact administration times, so option B cannot be definitively selected.

C. Assess the client for an allergy to penicillin: Since ampicillin is a penicillin-class antibiotic, it is essential for the nurse to assess the client for any history of allergies to penicillin or other beta-lactam antibiotics. A penicillin allergy could lead to a severe allergic reaction, so it is crucial to identify any potential allergies before administering the medication.

D. Document giving the medications: After administering the ampicillin, the nurse should document the administration in the client's medical record, including the time, dose, route, and any relevant observations or assessments.

E. Obtain a sputum for culture and sensitivity: The client's new prescription for ampicillin may be related to an infection. To ensure appropriate and effective treatment, obtaining a sputum specimen for culture and sensitivity is necessary. This will help identify the specific bacteria causing the respiratory infection and determine which antibiotics will be most effective in treating it.