The nurse is caring for a client who is being discharged with a prescription for tetracycline. Which of the following statements, if made by the client. demonstrates an understanding of the discharge instructions?

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.

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.