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 C

Explanation

A. "Expect your urine to turn pink or red while taking this medication."

This statement is incorrect. Vancomycin does not typically cause urine discoloration. However, red man syndrome, characterized by flushing of the skin, particularly on the face and upper body, can occur with rapid infusion of vancomycin. This is not related to urine color change.

B. "Discontinue the medication once your symptoms subside."

This statement is incorrect. It's crucial for the client to complete the full course of antibiotics as prescribed, even if symptoms improve before completing the treatment course. Discontinuing the medication prematurely can lead to the development of antibiotic resistance and recurrence of the infection.

C. "Notify your provider if you experience any changes in your hearing."

This statement is correct. Vancomycin can potentially cause ototoxicity, which may manifest as changes in hearing, including ringing in the ears (tinnitus) or hearing loss. Clients should be instructed to report any such symptoms to their healthcare provider promptly.

D. "Decrease your fluid intake to 1000ml per day."

This statement is incorrect. Adequate hydration is essential, especially when taking medications like vancomycin, to help prevent kidney damage and promote drug elimination. Restricting fluid intake is not advisable unless specifically instructed by the healthcare provider for a particular medical reason.

A. never take with prescription medications B. use only one herbal preparation at a time C. take less than the recommended dose initially D. check with a reputable pharmacist

Correct Answer is B

Explanation

A. Never take with prescription medications:

This statement is not accurate. Many herbal products can interact with prescription medications, potentially leading to adverse effects or reduced efficacy. However, avoiding taking herbal products with prescription medications altogether may not be practical or necessary in all cases. Instead, it's essential to assess for potential interactions and consult with healthcare professionals.

B. Use only one herbal preparation at a time:

This is the correct approach. Using only one herbal preparation at a time allows for better identification of any allergic reactions or adverse effects. If multiple herbal products are taken simultaneously, it can be challenging to determine which product is causing a particular reaction. Starting with one product also simplifies monitoring for efficacy and safety.

C. Take less than the recommended dose initially:

While starting with a lower dose initially may be a prudent approach for some individuals, it is not necessarily the best way to identify allergic or adverse reactions. Taking less than the recommended dose may not provide a full assessment of the product's effects and may not adequately identify potential adverse reactions.

D. Check with a reputable pharmacist:

Consulting with a reputable pharmacist is essential for obtaining information about herbal products, including potential interactions, side effects, and recommended dosages. While a pharmacist can provide valuable guidance, they may not be present during the initial use of the herbal product to monitor for adverse reactions directly.

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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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