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","B","C","D","F"]
Explanation
Choice A rationale
Assessing the client’s gag reflex before offering oral intake is essential to prevent aspiration. The gag reflex may be diminished after moderate sedation and the use of local anesthetics during bronchoscopy.
Choice B rationale
Listening to the client’s breath sounds is important to detect any abnormalities, such as wheezing, crackles, or decreased breath sounds, which could indicate complications like bronchospasm or pneumothorax.
Choice C rationale
Monitoring the client’s oxygen saturation is crucial to ensure adequate oxygenation and detect any signs of respiratory distress or hypoxemia following the procedure.
Choice D rationale
Monitoring the client for manifestations of bleeding is necessary because bronchoscopy can cause trauma to the airways, leading to bleeding. Signs of bleeding may include hemoptysis or a drop in hemoglobin levels.
Choice E rationale
Assessing the client’s puncture site is not applicable in this context, as bronchoscopy does not involve a puncture site. This option is incorrect.
Choice F rationale
Observing the client for manifestations of a pneumothorax is important because bronchoscopy can occasionally cause a pneumothorax, especially if a biopsy is performed. Signs of pneumothorax include sudden chest pain, dyspnea, and decreased breath sounds on the affected side. .
Correct Answer is D
Explanation
Choice A rationale
Asthma is not a contraindication for sumatriptan. Sumatriptan is a selective serotonin receptor agonist used to treat migraines by constricting blood vessels in the brain. It does not have a significant impact on respiratory conditions like asthma.
Choice B rationale
Kidney disease is not a contraindication for sumatriptan. However, caution is advised when using sumatriptan in patients with severe renal impairment due to potential accumulation of the drug and its metabolites.
Choice C rationale
Rheumatoid arthritis is not a contraindication for sumatriptan. Sumatriptan’s mechanism of action does not interfere with the inflammatory processes involved in rheumatoid arthritis.
Choice D rationale
Coronary artery disease (CAD) is a contraindication for sumatriptan. Sumatriptan can cause vasoconstriction of coronary arteries, which can exacerbate CAD and increase the risk of myocardial infarction or other cardiac events.