A client who is newly diagnosed with metastatic breast cancer is being prepared for chemotherapy. Which of the following adverse effects below should the nurse educate the client regarding chemotherapy?
(Select All that Apply.)

A. Regular sun exposure is needed to maximize drug efficacy: This is incorrect; in fact, doxycycline can cause photosensitivity, and sun exposure should be minimized.

B. Avoid water while taking this medication: Water should be taken with doxycycline to help prevent esophageal irritation.

C. Take this medication with antacids to relieve gastrointestinal symptoms: Antacids can also interfere with doxycycline absorption, so they should be avoided.

D. Avoid dairy products when taking this medication: Dairy products can bind to doxycycline and reduce its absorption in the gastrointestinal tract, which decreases its effectiveness. The client should avoid dairy when taking the medication.

The nurse understands that neomycin may cause serious adverse effects such as ototoxicity and

pseudomembranous colitis.

i. Ototoxicity: Neomycin is part of the aminoglycoside class of antibiotics, which are known to cause ototoxicity, potentially leading to hearing loss, tinnitus, or balance issues. The risk is particularly high in young children or when administered at high doses over long periods.

Rationale for other options:

• Constipation: This is not a known serious adverse effect of neomycin.
• Hypercalcemia: Elevated calcium levels (hypercalcemia) are not typically associated with neomycin use.
• Thrombocytopenia: While aminoglycosides can occasionally cause hematologic effects, thrombocytopenia (low platelet count) is not a common adverse effect of neomycin.

ii. Pseudomembranous colitis: Neomycin, like other antibiotics, can disrupt the normal balance of gut flora, leading to an overgrowth of Clostridioides difficile, which can cause pseudomembranous colitis, a severe inflammatory condition of the colon.

Rationale for other options:

• Hypotrichosis: This refers to reduced hair growth and is not related to neomycin. It can cause hypertrichosis instead.
• Photosensitivity: Neomycin is not known to cause photosensitivity reactions.
• Hyperpigmentation: Neomycin typically causes hypopigmentation.