A nurse is caring for a client receiving an intermittent IV bolus of gentamicin twice daily. Which of the following laboratory values should the nurse monitor while the client is receiving this medication? (Select all that apply.)
Glucose.
Prothrombin time.
Serum creatinine.
Cardiac enzymes.
WBC count.
Correct Answer : C,E
Choice A rationale
Monitoring glucose levels is not typically necessary for patients receiving gentamicin, as it does not significantly affect glucose metabolism.
Choice B rationale
Prothrombin time is not commonly affected by gentamicin, so routine monitoring is not required.
Choice C rationale
Serum creatinine levels should be monitored to assess kidney function, as gentamicin can cause nephrotoxicity.
Choice D rationale
Cardiac enzymes are not typically affected by gentamicin, so routine monitoring is not necessary.
Choice E rationale
Monitoring WBC count is important to detect any signs of infection or bone marrow suppression, which can occur with gentamicin use.
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Correct Answer is C
Explanation
Choice A rationale
Mannitol is an osmotic diuretic used primarily to reduce intracranial pressure (ICP) and treat cerebral edema. It does not affect thyroxine levels, which are related to thyroid function. Thyroxine levels are regulated by the thyroid gland and are not influenced by mannitol administration.
Choice B rationale
Mannitol is not used to correct atrial flutter. Atrial flutter is a type of arrhythmia that requires specific antiarrhythmic medications or procedures such as cardioversion. Mannitol’s primary action is to increase osmotic pressure in the kidneys, leading to diuresis and reduction of fluid in tissues, including the brain.
Choice C rationale
Mannitol is effective in reducing intracranial pressure by creating an osmotic gradient that draws fluid from the brain tissue into the bloodstream, which is then excreted by the kidneys. This reduction in intracranial pressure is a desired therapeutic outcome when treating conditions like cerebral edema.
Choice D rationale
Mannitol does not increase hemoglobin levels. Hemoglobin levels are influenced by factors such as red blood cell production and destruction, iron levels, and overall health status. Mannitol’s mechanism of action is related to fluid balance and diuresis, not hematopoiesis.
Correct Answer is B
Explanation
Choice A rationale
BNP is used to diagnose heart failure, not to monitor gentamicin’s adverse effects.
Choice B rationale
Creatinine levels should be monitored as gentamicin can cause nephrotoxicity, leading to impaired kidney function.
Choice C rationale
Amylase levels are not relevant for detecting gentamicin’s adverse effects.
Choice D rationale
ESR is used to detect inflammation, not specific to gentamicin’s adverse effects.