Mrs. Oza, age 69, has hypertension and has one functioning kidney. She loves chocolates and enjoys an alcoholic beverage twice a week. Her hobby is gardening and she goes for long walks despite having arthritis. Which one of the following pieces of information is likely to have the greatest significance if she is prescribed vancomycin?

She only has one functioning kidney

She remains outdoors for long periods of time

She has hypertension

She enjoys an alcoholic beverage twice a week

Answer and Explanation

The Correct Answer is A

A. She only has one functioning kidney:

This choice is the most significant consideration when prescribing vancomycin to Mrs. Oza. Vancomycin is primarily eliminated from the body through the kidneys. Individuals with reduced kidney function, such as Mrs. Oza with only one functioning kidney, have a higher risk of vancomycin-associated nephrotoxicity (kidney damage). Therefore, her renal status is crucial information for determining the appropriate dosage of vancomycin and monitoring for any signs of kidney impairment during treatment.

B. She remains outdoors for long periods of time:

While spending time outdoors for long periods may have implications for Mrs. Oza's overall health, it is not directly relevant to the prescription of vancomycin. This information may be important for considering sun exposure, hydration, and other factors related to her arthritis and general well-being, but it does not specifically impact the pharmacokinetics or pharmacodynamics of vancomycin.

C. She has hypertension:

Mrs. Oza's hypertension is a relevant medical condition to consider in her overall health management. However, hypertension alone does not directly affect the prescription of vancomycin. Hypertension may influence the choice of antihypertensive medications or other aspects of her medical care, but it does not have a direct impact on the renal clearance or potential nephrotoxicity of vancomycin.

D. She enjoys an alcoholic beverage twice a week:

While alcohol consumption can interact with certain medications and impact overall health, it is not the most significant consideration when prescribing vancomycin to Mrs. Oza. Moderate alcohol consumption is unlikely to directly affect the pharmacokinetics or pharmacodynamics of vancomycin. However, excessive alcohol intake may contribute to liver dysfunction, which could indirectly influence drug metabolism. Nonetheless, in Mrs. Oza's case, her reduced renal function is a more critical factor to consider when prescribing vancomycin.

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Correct Answer is B

Explanation

A.Green leafy vegetables:

There is no specific recommendation to avoid green leafy vegetables while taking tetracycline. However, it’s generally advisable to take tetracycline on an empty stomach, as certain foods and supplements containing calcium, magnesium, aluminum, iron, or zinc can interfere with the absorption of tetracycline if consumed concurrently. Green leafy vegetables are not typically high in these minerals, so there is no need to avoid them specifically.

B. Sunlight:

Tetracycline antibiotics, including Sumycin, can increase the skin’s sensitivity to sunlight and UV radiation, leading to an increased risk of sunburn and photosensitivity reactions. Therefore, clients taking tetracycline should be advised to minimize sun exposure, wear protective clothing, and use sunscreen with a high sun protection factor (SPF) to reduce the risk of sunburn and skin damage.

C. Exercise:

There is no specific contraindication to exercise while taking tetracycline. In fact, regular exercise can promote overall health and well-being. However, it’s essential for clients to listen to their bodies and avoid strenuous exercise if they experience any adverse effects or symptoms while taking tetracycline or any other medication.

D. Foods high in tyramine:

Tetracycline antibiotics do not interact with tyramine-containing foods in the same way as certain other classes of antibiotics, such as monoamine oxidase inhibitors (MAOIs). Therefore, there is no specific need to avoid foods high in tyramine while taking tetracycline, as tyramine-related interactions are not typically associated with tetracycline use.

A. changes in mental status B. complaints that he is unable to hear the television C. an increase in the BUN and creatinine D. tingling of the extremities

Correct Answer is B

Explanation

A. Changes in mental status:

Changes in mental status are not typically associated with ototoxicity caused by gentamicin. Mental status changes may indicate other systemic effects or adverse reactions, but they are not specific to ototoxicity.

B. Complaints that he is unable to hear the television:

This complaint is highly indicative of ototoxicity. Hearing loss, particularly high-frequency hearing loss, is a common symptom of ototoxicity caused by drugs like gentamicin. Difficulty hearing sounds such as the television, especially at typical volume levels, suggests a potential problem with hearing function.

C. An increase in the BUN and creatinine:

An increase in blood urea nitrogen (BUN) and creatinine levels may indicate kidney damage, which can occur as a result of nephrotoxicity associated with gentamicin use. While nephrotoxicity is a known adverse effect of gentamicin, it is not specific to ototoxicity.

D. Tingling of the extremities:

Tingling of the extremities is not typically associated with ototoxicity caused by gentamicin. This symptom may suggest other neurological or systemic effects but is not specific to ototoxicity.

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Naxlex Comprehensive Predictor Exams

The nurse is instructing a client who has been prescribed tetracycline (Sumycin). What should the nurse advise this client to avoid while taking this medication?

Correct Answer is B

Explanation

Which of the following complaints by a man taking gentamycin would be most indicative that he is experiencing ototoxicity?

Correct Answer is B

Explanation

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