When a patient is undergoing aminoglycoside therapy, which indicators should the nurse monitor for potential toxicity?

Decreased blood urea nitrogen (BUN) levels

Fever

White blood cell count of 5000 cells/mm

Tinnitus and dizziness

Answer and Explanation

The Correct Answer is D

Choice A rationale:

Aspirin is known as a salicylate and a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking a certain natural substance in your body to reduce pain and swelling. However, one of the key reasons aspirin is administered to a patient with a history of myocardial infarction (MI) is due to its antiplatelet aggregate properties. This effect reduces the risk of stroke and heart attack. If a patient has recently had surgery on clogged arteries (such as bypass surgery, carotid endarterectomy, coronary stent), doctors may direct them to use aspirin in low doses as a “blood thinner” to prevent blood clots.

Choice B rationale:

While aspirin does have analgesic properties, meaning it can relieve mild to moderate pain from conditions such as muscle aches, toothaches, common cold, and headaches, this is not the primary reason it would be administered to a patient with a history of MI. The main goal in this context is to prevent further cardiac events, which is achieved through aspirin’s antiplatelet effects.

Choice C rationale:

Aspirin does have anti-inflammatory properties and it may be used to reduce pain and swelling in conditions such as arthritis. However, in the context of a patient with a history of MI, the anti-inflammatory property is not the primary reason for administering aspirin. The key purpose is to leverage its antiplatelet effects to prevent further cardiac events.

Choice D rationale:

Aspirin can be used to reduce fever, which is what the term ‘antipyretic’ refers to. However, similar to the analgesic and antiinflammatory properties, the antipyretic property is not the primary reason for administering aspirin to a patient with a history of MI. The main goal is to prevent further cardiac events through its antiplatelet effects.

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Correct Answer is C

Explanation

Choice A rationale:

Proton pump inhibitors (PPIs) are used extensively for the treatment of gastric acid-related disorders, often over the long term, which raises the potential for clinically significant drug interactions in patients receiving concomitant medications.

However, there is no specific mention of a significant interaction between PPIs and aminoglycosides.

Choice B rationale:

Aminoglycoside antibiotics and calcium channel blockers can interact at the neuromuscular junctions. This interaction is of clinical significance because when these agents are given concurrently during the perioperative period they may lead to respiratory depression or prolonged apnea. However, this is not directly related to the therapeutic effect of aminoglycosides, but rather a side effect of their combined use.

Choice C rationale:

The loop-diuretics (ethacrynic acid, furosemide, bumetamide) and aminoglycoside antibiotics (kanamycin, gentamicin, tobramycin, amikacin, etc.) are important drugs frequently used to treat seriously ill patients. Not uncommonly both types of drugs are given to the same patient exposing that patient to the risk of a hearing loss (ototoxicity)5. In addition, the risk of ototoxicity could be enhanced by the concomitant use of loop diuretics and aminoglycoside antibiotics.

Choice D rationale:

Phenytoin is a medication used to treat seizures. It has a complex pharmacokinetic profile and can interact with many other drugs. However, there is no specific mention of a significant interaction between phenytoin and aminoglycosides.

Correct Answer is ["2.5 "]

Explanation

Step 1: Identify the given values. The nurse needs to administer 2.5 mg of hydromorphone. The available amount is 5 mg/5 mL.

Step 2: Set up the calculation. We need to find out how many mL correspond to 2.5 mg. We can set up a proportion using the given values:

5 mL5 mg=x mL2.5 mg

Step 3: Solve for x. Cross-multiply and solve for x:

5 mg×x mL=2.5 mg×5 mL

Step 4: Simplify the equation:

x=5 mg.5 mg×5 mL

Step 5: Calculate the value of x:

x=2.5 mL

So, the nurse should administer 2.5 mL of the hydromorphone elixir.

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When a patient is undergoing aminoglycoside therapy, which indicators should the nurse monitor for potential toxicity?

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Naxlex Comprehensive Predictor Exams

The nurse is reviewing the medication orders for a patient who will be receiving aminoglycoside therapy. Which other medication or medication class, if ordered, would be a potential interaction concern?

Correct Answer is C

Explanation

A nurse is preparing to administer hydromorphone 2.5 mg. The available amount is 5 mg/5 mL elixir. How many mL should the nurse administer?

Correct Answer is ["2.5 "]

Explanation

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