Which of the following types of patients are more vulnerable to drug toxicity?

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.

A. Antibiotic dosages below the minimum concentration are prescribed:

This statement is incorrect. When treating MRSA infections, it's essential to prescribe antibiotic dosages that achieve adequate concentrations to effectively combat the resistant bacteria. Suboptimal dosages or inadequate duration of treatment can contribute to treatment failure and the development of antibiotic resistance. Therefore, the nurse should emphasize the importance of prescribing appropriate dosages of antibiotics for MRSA infections.

B. Broad-spectrum antibiotics are used whenever possible:

This statement is not accurate. While broad-spectrum antibiotics may be effective against a wide range of bacteria, they are not always the preferred choice for treating MRSA infections. MRSA is resistant to many antibiotics, including those commonly used as broad-spectrum agents. Therefore, the treatment of MRSA typically involves antibiotics that are specifically effective against this resistant strain, such as vancomycin, daptomycin, linezolid, or other agents based on susceptibility testing. Therefore, the nurse should educate the client that specific antibiotics effective against MRSA are used, rather than relying solely on broad-spectrum antibiotics.

C. Antibiotics are prescribed only when a viral infection is present:

This statement is incorrect. Antibiotics are not effective against viral infections, including those caused by viruses such as influenza or the common cold. MRSA is a bacterial infection, and antibiotics are indicated for its treatment. However, it's essential to use antibiotics judiciously and only when necessary to avoid contributing to antibiotic resistance. The nurse should educate the client that antibiotics are prescribed for bacterial infections like MRSA, but they are not appropriate for viral infections.

D. Infections become resistant to high doses of antibiotics:

This statement is accurate. Overuse or inappropriate use of antibiotics, including high doses, can contribute to the development of antibiotic resistance. Bacteria like MRSA can acquire resistance mechanisms that render antibiotics ineffective, even at high doses. Therefore, it's crucial to use antibiotics judiciously, following appropriate dosing guidelines and duration of treatment, to minimize the risk of antibiotic resistance. The nurse should include this information in the teaching to emphasize the importance of responsible antibiotic use in the management of MRSA infections.