Before starting antimicrobial therapy, the nurse assesses a patient for possible drug allergy. Which of the following complaints should alert the nurse to a drug allergy?

A. The patient stops taking the drug when he or she begins to feel better:

This choice refers to the common habit where patients discontinue their prescribed medication once they start to feel improvement in their symptoms, even if they haven't completed the full course of treatment. This premature cessation of medication can leave some microbes alive and potentially resistant to the antibiotic, allowing them to regrow and cause a recurrence of the infection.

B. The patient switches to multiple drug therapy from single drug therapy:

This choice describes a scenario where a patient switches from a single drug therapy to multiple drug therapy. While this may be a valid treatment approach in some cases, it is not directly related to the re-population and re-establishment of microbes causing an infection.

C. The patient uses OTC drugs prophylactically:

This choice involves patients using over-the-counter (OTC) drugs preventively without consulting a healthcare professional. While OTC drugs may have their own set of issues, such as contributing to antibiotic resistance, this behavior isn't specifically linked to the re-population and re-establishment of microbes causing an infection.

D. The patient increases the drug dosage when he or she perceives that the therapeutic effect of the drug is slowing down:

This choice describes a scenario where a patient independently increases the dosage of their medication without consulting a healthcare provider. While inappropriate dosage adjustments can lead to adverse effects, it doesn't directly address the re-population and re-establishment of microbes causing an infection.

A. Ototoxicity:

Ototoxicity refers to damage to the auditory and vestibular nerves, leading to hearing loss and balance disturbances. Gentamicin, being an aminoglycoside antibiotic, is known for its potential to cause ototoxicity. Signs and symptoms of ototoxicity include changes in hearing, ringing in the ears (tinnitus), and imbalance. Ototoxicity is irreversible and can occur suddenly or gradually during gentamicin therapy. Therefore, any signs or symptoms of ototoxicity should be reported immediately to the physician for further evaluation and management.

B. Nausea:

Nausea is a common gastrointestinal side effect associated with gentamicin therapy. While it can be bothersome to the patient, nausea alone is not typically considered a severe adverse effect that requires immediate reporting to the physician. However, if nausea is severe or persistent and leads to dehydration or electrolyte imbalances, it should be addressed promptly.

C. Constipation:

Constipation is another potential gastrointestinal side effect of gentamicin therapy. Like nausea, constipation alone is not typically considered a severe adverse effect that requires immediate reporting to the physician. However, if constipation is severe or persistent and leads to discomfort or bowel obstruction, it should be addressed promptly.

D. Increased urinary output:

Increased urinary output may indicate improved renal function, which can be a desired effect during gentamicin therapy. Gentamicin is primarily excreted by the kidneys, and increased urinary output may help in the elimination of the drug from the body. Therefore, increased urinary output alone is not typically considered an adverse effect that requires immediate reporting to the physician. However, if there are signs of dehydration or electrolyte imbalances associated with increased urinary output, they should be addressed promptly.