Which of the following complaints by a man taking gentamycin would be most indicative that he is experiencing ototoxicity?

A. A Vitamin C deficiency:

While a Vitamin C deficiency can lead to oral health issues such as bleeding gums or scurvy, it is less likely to present with bright red oral mucous membranes and white patches. Vitamin C deficiency typically manifests with other symptoms such as fatigue, weakness, and joint pain.

B. Dehydration:

Dehydration can cause dry mouth and oral discomfort, but it is less likely to present with bright red oral mucous membranes and white patches. Dehydration may also result in a dry, sticky feeling in the mouth rather than soreness with white patches.

C. Poor oral hygiene:

Poor oral hygiene can lead to various oral health problems, including gingivitis and dental caries, but it is less likely to cause bright red oral mucous membranes with white patches. Poor oral hygiene typically results in plaque accumulation, gum inflammation, and dental decay rather than the specific symptoms described.

D. A superinfection:

This is the correct option. A superinfection occurs when opportunistic microorganisms, such as fungi or resistant bacteria, proliferate and cause infection following antibiotic therapy. Penicillin, like other antibiotics, can disrupt the normal balance of microorganisms in the mouth, allowing opportunistic pathogens to flourish and lead to conditions such as oral thrush (caused by Candida albicans) or oral candidiasis. The presence of bright red oral mucous membranes with white patches suggests the possibility of a superinfection, which warrants immediate attention from the primary care provider for further evaluation and management.

A. “It’s fine for me to become pregnant while taking this medication.”

This statement is incorrect. Tetracycline is known to have teratogenic effects, meaning it can harm the developing fetus if taken during pregnancy. Women of childbearing age should use effective contraception while taking tetracycline and avoid becoming pregnant during treatment.

B. “I will need to postpone my vacation at the beach until I finish this medication."

This statement demonstrates an understanding of the discharge instructions. Tetracycline can increase the risk of sunburn and photosensitivity reactions. Therefore, it's advisable for the client to avoid prolonged sun exposure, particularly during peak sunlight hours, and to use sun protection measures such as wearing protective clothing, using sunscreen, and avoiding tanning beds or sunlamps. Postponing a vacation at the beach until after finishing the medication is a prudent precaution to minimize the risk of sun-related side effects.

C. “I am so glad to be leaving today because I have an appointment at the tanning salon."

This statement is incorrect. Tetracycline can increase the risk of sunburn and photosensitivity reactions. Visiting a tanning salon while taking tetracycline can further increase the risk of skin damage and should be avoided.

D. "I will stop taking this medication as soon as I feel better.”

This statement is incorrect. It's important for the client to complete the full course of tetracycline as prescribed by their healthcare provider, even if they start to feel better before finishing the medication. Stopping the medication prematurely can lead to incomplete treatment and potential recurrence of the infection.