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 D
Explanation
Choice A rationale
Phenytoin is an anticonvulsant used to control seizures and is not indicated for the treatment of adrenal insufficiency.
Choice B rationale
Calcitonin is used to treat conditions like osteoporosis and hypercalcemia, not adrenal insufficiency.
Choice C rationale
Buspirone is an anxiolytic used to treat anxiety disorders and is not used for adrenal insufficiency.
Choice D rationale
Fludrocortisone is a synthetic corticosteroid that is used to replace aldosterone in patients with adrenal insufficiency. It helps maintain sodium balance and blood pressure.
Correct Answer is B
Explanation
Choice A rationale
Decreased excretion of urine sodium is not an expected therapeutic effect of bumetanide. Bumetanide is a loop diuretic that works by inhibiting the reabsorption of sodium and chloride in the ascending loop of Henle, leading to increased excretion of sodium and water.
Choice B rationale
Increased urinary output is the expected therapeutic effect of bumetanide. As a potent loop diuretic, bumetanide increases the excretion of water and electrolytes, which helps reduce fluid accumulation in conditions like ascites.
Choice C rationale
Decreased serum glucose is not associated with bumetanide. Bumetanide primarily affects fluid and electrolyte balance and does not have a significant impact on blood glucose levels.
Choice D rationale
Increased blood pressure is not an expected effect of bumetanide. On the contrary, bumetanide can help lower blood pressure by reducing fluid volume and decreasing the workload on the heart.