The nurse is caring for a client receiving gentamycin IV. Which of the following adverse effects would the nurse report to the physician immediately?

Ototoxicity

Nausea

Constipation

Increased urinary output

Answer and Explanation

The Correct Answer is A

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.

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Correct Answer is D

Explanation

A. Antagonistic reaction:

An antagonistic reaction refers to a response where one substance opposes the action of another substance. In the context of hypersensitivity reactions, this term does not accurately describe the immune system's response to an allergen. Hypersensitivity reactions involve an overreaction of the immune system to a harmless substance, rather than opposing actions between substances. Therefore, choice A is not the correct term to describe hypersensitivity reactions.

B. Drug idiosyncrasy:

Drug idiosyncrasy refers to an unusual or unexpected response to a medication that is not related to the known pharmacological properties of the drug or the patient's characteristics. While idiosyncratic drug reactions can sometimes involve immune-mediated mechanisms, they are not synonymous with hypersensitivity reactions. Hypersensitivity reactions specifically involve the immune system's exaggerated response to an allergen, which may or may not be a medication. Therefore, while drug idiosyncrasy may involve unpredictable reactions, it does not specifically address the immune-mediated nature of hypersensitivity reactions.

C. Synergistic reaction:

A synergistic reaction occurs when the combined effect of two substances is greater than the sum of their individual effects. In the context of hypersensitivity reactions, this term does not accurately describe the immune system's response to an allergen. Hypersensitivity reactions involve an exaggerated response of the immune system to an allergen, rather than a synergistic interaction between substances. Therefore, choice C is not the correct term to describe hypersensitivity reactions.

D. Allergic reaction:

An allergic reaction is the correct term to describe hypersensitivity reactions. Hypersensitivity reactions involve the immune system's exaggerated response to a harmless substance, known as an allergen. This response can manifest in various symptoms, ranging from mild to severe, depending on the individual's sensitivity and the nature of the allergen. Allergic reactions can affect different organ systems and can be triggered by a wide range of substances, including foods, medications, environmental allergens, and insect venom. Therefore, choice D accurately describes hypersensitivity reactions.

A. An infection that is difficult to treat B. An infection caused by a weakened immune system C. A secondary infection that occurs when microorganisms normally present in the body are killed by the drug D. A drug resistant infection

Correct Answer is C

Explanation

A. An infection that is difficult to treat:

This choice describes a challenging infection but does not specifically capture the concept of a superinfection. While superinfections can indeed be difficult to treat, they are defined more specifically as secondary infections that occur due to disruption of the normal microbial flora during the treatment of an initial infection.

B. An infection caused by a weakened immune system:

This choice describes an infection that occurs due to a compromised or weakened immune system, which can indeed increase the risk of developing infections, including superinfections. However, it does not fully encompass the definition of a superinfection, which specifically involves the overgrowth of opportunistic pathogens after the disruption of normal microbial flora by antimicrobial treatment.

C. A secondary infection that occurs when microorganisms normally present in the body are killed by the drug:

This choice accurately describes what a superinfection is. It highlights the key concept that a superinfection is a secondary infection that arises when antimicrobial treatment disrupts or kills the normal microbial flora of the body, allowing opportunistic pathogens to overgrow and cause infection.

D. A drug-resistant infection:

This choice describes an infection caused by microorganisms that are resistant to the effects of antimicrobial drugs. While drug resistance is a significant concern in healthcare, it does not specifically define a superinfection. Superinfections can involve drug-resistant microorganisms, but they are not solely characterized by drug resistance; rather, they are secondary infections resulting from the disruption of normal microbial flora during antimicrobial treatment.

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The nurse is caring for a client receiving gentamycin IV. Which of the following adverse effects would the nurse report to the physician immediately?

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