The nurse is admitting a client to the acute care floor with methicillin-resistant S. aureus. The nurse would expect the physician to order which of the following medications for the client?

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.

A. Not affected:

This choice suggests that taking ciprofloxacin with antacids does not alter its absorption. However, this is not correct. When ciprofloxacin is taken with antacids containing certain ions (such as aluminum, magnesium, or calcium), the absorption of ciprofloxacin can indeed be affected due to the formation of insoluble complexes, leading to decreased absorption.

B. Delayed:

This choice implies that taking ciprofloxacin with antacids delays its absorption. While it's true that the interaction between ciprofloxacin and certain antacids can alter absorption, the main effect is not typically a delay in absorption but rather a decrease due to the formation of insoluble complexes. Therefore, while "delayed" may somewhat describe the effect, it doesn't fully capture the nature of the interaction.

C. Increased:

This choice suggests that taking ciprofloxacin with antacids increases its absorption. However, this is not accurate. Antacids containing aluminum, magnesium, or calcium can interfere with the absorption of ciprofloxacin by forming insoluble complexes with the drug, leading to decreased absorption rather than an increase.

D. Decreased:

This choice correctly identifies the effect of taking ciprofloxacin with antacids. When ciprofloxacin is taken concurrently with antacids containing aluminum, magnesium, or calcium, the absorption of ciprofloxacin is decreased. The ions in the antacids bind with ciprofloxacin in the gastrointestinal tract, forming insoluble complexes that are poorly absorbed, thereby reducing the effectiveness of the antibiotic.