The nurse is administering the sixth IV dose of gentamicin to a client with extensive full thickness burns. Which assessment finding warrants further intervention?

Reference Range:

White Blood Cell [5000 to 10,000/mm3 (5 to 10 x 10 %/L)] Blood Urea Nitrogen [10 to 20 mg/dL (3.6 to 7.1 mmol/L)] Creatinine [0.5 to 1.1 mg/dL (44 to 97 µmol/L)]

Serum creatinine level of 1.6 mg/l. (141 µmol), a blood urea nitrogen (BUN) of 20 mg/dL.(7.1 mmol/L)

Reports a sore mouth and three episodes of diarrhea that began this morning.

White blood count of 9,000/mm3 (9 x 109/L) and an oral temperature of 98.2° F (36.7° C) two hours ago.

Urinary output of 400 ml of clear, amber colored urine in the past eight hours.

Answer and Explanation

The Correct Answer is A

A. Serum creatinine level of 1.6 mg/dL (141 µmol/L), a blood urea nitrogen (BUN) of 20 mg/dL (7.1 mmol/L): Gentamicin is an aminoglycoside that is known for its nephrotoxic potential. Elevated serum creatinine and BUN levels are indicative of impaired kidney function, which warrants further investigation and possible intervention. This finding is significant because it may reflect kidney damage or reduced renal clearance of the drug.
B. Reports a sore mouth and three episodes of diarrhea that began this morning: While these symptoms are important and could suggest a possible adverse effect or secondary infection, they are not as immediately concerning in the context of gentamicin therapy as the potential for kidney damage indicated by elevated creatinine and BUN levels.
C. White blood count of 9,000/mm³ (9 x 10^9/L) and an oral temperature of 98.2°F (36.7°C) two hours ago: These values are within normal ranges and do not suggest an immediate concern related to gentamicin toxicity.
D. Urinary output of 400 mL of clear, amber-colored urine in the past eight hours: While monitoring urinary output is important, this level of output does not necessarily indicate a problem in the context of gentamicin therapy compared to elevated creatinine and BUN levels.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Restlessness: Restlessness is a sign of excessive levothyroxine sodium, which can lead to symptoms of hyperthyroidism. Other signs include palpitations, nervousness, and insomnia. Overmedication can accelerate metabolism and cause these symptoms.
B. Decreased appetite: Decreased appetite is not typically associated with overmedication of levothyroxine. Instead, a decreased appetite might be related to other conditions or medications but is not a primary indicator of excessive thyroid hormone.
C. Intolerance to cold: Intolerance to cold is more indicative of hypothyroidism or insufficient dosing of levothyroxine rather than overmedication. Excessive levothyroxine usually causes symptoms of hyperthyroidism, such as heat intolerance.
D. Constipation: Constipation is more commonly associated with hypothyroidism or insufficient levothyroxine dosing. Overmedication generally leads to symptoms like diarrhea rather than constipation.

A. Taking an antiemetic medication. B. Allergy to aspirin. C. Currently pregnant. D. History of glaucoma.

Correct Answer is C

Explanation

A. Taking an antiemetic medication: This information is not directly relevant before administering misoprostol. Misoprostol does not typically interact with antiemetic medications in a way that would change the administration plan.
B. Allergy to aspirin: While important to know for general medication safety, misoprostol's primary concern is its potential effects on pregnancy rather than an allergy to aspirin.
C. Currently pregnant: Misoprostol is contraindicated in pregnancy due to its potential to induce uterine contractions and cause miscarriage. It is crucial to confirm that the patient is not pregnant before administering this medication.
D. History of glaucoma: While important for other medications, a history of glaucoma is not a primary concern when administering misoprostol.

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Naxlex Comprehensive Predictor Exams

Levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much levothyroxine sodium.

Correct Answer is A

Explanation

Prior to administration of the initial dose of the gastrointestinal (GI) agent misoprostol, which information should the nurse obtain from the patient?

Correct Answer is C

Explanation

The nurse is administering the angiotensin II receptor antagonist valsartan. Which physiological response causes its therapeutic effect?

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