A male client has been receiving the antibiotic gentamicin sulfate, IV piggyback every 12 hours for several days. Which observation by the nurse indicates that the client may be experiencing an adverse effect of gentamicin?
Reference Range: White Blood Cell [5000 to 10,000/mm3 (5 to 10 x 109/L)]
White blood cell count of 6,000/mm3 (6 x 109/L).
Decreased blood urea nitrogen.
Hearing has decreased.
Reports of photophobia.
The Correct Answer is C
Rationale:
A. A WBC count within the normal range does not indicate an adverse effect of gentamicin.
B. Gentamicin is more likely to increase BUN levels due to nephrotoxicity rather than decrease them.
C. Gentamicin is an aminoglycoside antibiotic known to cause ototoxicity, which can lead to hearing loss. Decreased hearing is a significant adverse effect that should be promptly addressed.
D. Photophobia is not a common side effect of gentamicin.
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Correct Answer is A
Explanation
Rationale:
A. Turning on overhead lights ensures that the client can see the instructions clearly, which is particularly important for older adults who may have visual impairments. Adequate lighting helps improve comprehension and reduces the risk of misunderstandings.
B. Standing behind the client may cause confusion or discomfort. It is better to face the client while communicating.
C. Handouts should be written at a lower reading level, typically around the 5th to 6th grade, to ensure that most clients can understand them, especially older adults.
D. Background music may be distracting rather than helpful during the provision of important instructions.
Correct Answer is A
Explanation
Rationale:
A.Dopamine, a sympathomimetic agent, can cause significant changes in blood pressure. Monitoring blood pressure every 15 minutes is crucial to assess the client's response to the medication and to detect any adverse effects, such as hypertension or hypotension, promptly.
B.Monitoring CBC is important but not as immediately critical in this situation as monitoring blood pressure.
C.While reviewing creatinine and BUN results is important for overall kidney function, it is not the most immediate priority when administering dopamine for shock.
D. Measuring urinary output is important for assessing renal perfusion but should be done more frequently than daily in a client receiving dopamine for shock.