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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)]

A.

White blood cell count of 6,000/mm3 (6 x 109/L).

B.

Decreased blood urea nitrogen.

C.

Hearing has decreased.

D.

Reports of photophobia.

Answer and Explanation

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 D

Explanation

Rationale:

A. Lubricating lotion may be helpful for dry skin but is not necessary for these lesions.

B. A biopsy is not typically required for benign lesions such as senile lentigines, unless there is suspicion of malignancy.

C. Recent international travel is unrelated to the development of senile lentigines.

D. Senile lentigines, also known as "liver spots" or "age spots," are common in older adults. They are benign lesions that result from sun exposure and aging. Recording their presence is appropriate for documentation, as they are generally not harmful.

Correct Answer is B

Explanation

Rationale:

A. While antibiotics can influence blood glucose, the primary reason for insulin in this context is the effect of steroids and infection on blood glucose levels.

B. Methylprednisolone, a steroid, can increase blood glucose levels, necessitating the use of insulin to manage elevated glucose levels during illness.

C. The need for insulin is related to the current hospitalization and medication effects, not necessarily a long-term change in diabetes management.

D. The ease of control is less relevant compared to the fact that steroids and infection can significantly impact blood glucose levels, necessitating insulin during hospitalization.

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