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 A
Explanation
Choice A rationale
A neutrophil count of 650/mm³ is significantly lower than the normal range (2,500 to 8,000/mm³) and indicates neutropenia, which is a known adverse effect of zidovudine. Neutropenia increases the risk of infections and requires close monitoring and potential dose adjustment or discontinuation of the medication.
Choice B rationale
A platelet count of 450,000/mm³ is slightly above the normal range (150,000 to 400,000/mm³) but is not typically associated with zidovudine toxicity. Zidovudine is more commonly associated with bone marrow suppression leading to anemia and neutropenia rather than thrombocytosis.
Choice C rationale
An Hgb level of 17 g/dL is above the normal range for females (12 to 16 g/dL) but is not a common adverse effect of zidovudine. Zidovudine is more likely to cause anemia, leading to lower hemoglobin levels rather than elevated levels.
Choice D rationale
A creatinine level of 1.5 mg/dL is within the upper limit of the normal range (0.5 to 1 mg/dL) and is not a typical adverse effect of zidovudine. Zidovudine primarily affects the bone marrow and does not have a significant impact on renal function.
Correct Answer is B
Explanation
Choice A rationale
Experiencing a rash while taking allopurinol is not harmless. It can be a sign of a serious allergic reaction, such as Stevens-Johnson syndrome or toxic epidermal necrolysis.
Choice B rationale
Increasing fluid intake is crucial when taking allopurinol. It helps to prevent kidney stones and ensures that uric acid is effectively excreted from the body.
Choice C rationale
Increasing dietary fiber intake is not specifically related to the use of allopurinol. While fiber is beneficial for overall health, it does not directly impact the effectiveness or safety of allopurinol.
Choice D rationale
Taking one dose every hour until the pain subsides is incorrect and dangerous. Allopurinol should be taken as prescribed by a healthcare provider, typically once or twice daily.