A patient has been newly prescribed gentamicin 120mg, IM, once.

After reviewing the patient’s home medication list, which medication should the nurse be most concerned about?

Choice A rationale
While a fasting blood sugar level of 130 mg/dL is slightly elevated, it is not the most concerning finding given the current medications. Metformin is a medication used to control blood sugar levels in patients with diabetes, so this patient’s blood sugar is being managed.
Choice B rationale
Yellow discoloration of the sclera is a sign of jaundice, which can indicate liver damage. Given that this patient is taking several medications that can potentially cause liver damage (including isoniazid and acetaminophen), this finding is most concerning.
Choice C rationale
A positive result on the tuberculin skin test indicates exposure to tuberculosis, but it does not necessarily mean the patient has active tuberculosis. The patient is currently taking medications for tuberculosis (isoniazid and rifampin), indicating that this condition is being managed.
Choice D rationale
A blood pressure reading of 100/70 mmHg is within the normal range, so this would not be the most concerning finding. The patient’s metoprolol medication is used to manage blood pressure, indicating that this aspect of the patient’s health is being managed. Prednisone Prednisone Explore

Choice A rationale
A persistent cough is not directly related to the administration of famotidine. Famotidine is a histamine-2 blocker that works by decreasing the amount of acid the stomach produces. It is used to treat and prevent ulcers in the stomach and intestines and to treat conditions in which the stomach produces too much acid. A persistent cough could be a symptom of many other conditions, but it is not a direct indicator of the effectiveness or ineffectiveness of famotidine.
Choice B rationale
The absence of a sour taste in the mouth, often associated with acid reflux, could suggest that famotidine is working as it should. However, the absence of a sour taste does not definitively indicate that the medication has had its intended effect, as the patient may not have experienced this symptom even before taking the medication.
Choice C rationale
Famotidine is used to decrease the amount of acid in the stomach. A normal stomach pH is typically around 1.5 to 3.5, which is highly acidic. If a patient’s stomach pH is measured at 5, which is less acidic than normal, it could suggest that the famotidine has not had its intended effect of reducing stomach acid.
Choice D rationale
While headaches are listed as a common side effect of famotidine, the presence of headaches does not necessarily suggest that the medication has not had its intended effect. Headaches could be caused by a variety of factors and are not a direct indicator of the level of stomach acid or the effectiveness of famotidine.