A nurse is caring for a 55-year-old client who requires antibiotic therapy.

Exhibits

A nurse is reviewing a client's medical record. Select the 4 findings that place the client at risk for hearing impairment.

Osteoarthritis

Place of employment

Gentamycin

Naproxen

Bumetanide

Heart failure

Answer and Explanation

Correct Answer : B,C,D,E

A.   Osteoarthritis is not associated with hearing loss
B.   The client's place of employment as a firearms instructor at a shooting range exposes them to loud noises, which is a well-known risk factor for hearing loss.
C.   Gentamycin is an aminoglycoside antibiotic that can be ototoxic, especially when administered in high doses or for prolonged periods, potentially leading to hearing loss.
D.   Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that has been associated with an increased risk of hearing loss, particularly when taken regularly or in high doses.
E.   Bumetanide is a loop diuretic that can also have ototoxic effects, especially when used in conjunction with aminoglycoside antibiotics like gentamycin.
F.   Heart failure is not associated with hearing loss

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Correct Answer is C

Explanation

A. Using a portable electronic thermometer is incorrect as the device must be dedicated to the client to avoid cross-contamination.
B. Wiping the stethoscope with alcohol after use is insufficient because alcohol-based sanitizers are ineffective against C. difficile spores. The stethoscope should be cleaned with bleach-based disinfectant.
C. Removing the protective gown before leaving the client's room is correct as it prevents the spread of C. difficile spores outside the isolation area.
D. Removing the protective gown before removing gloves is incorrect. Gloves should be removed first to prevent contamination when removing the gown.

A. HbA1c level of 7.5% (nl. 4.4-6.4%) B. 2-hour post-prandial blood glucose level of 122 mg/dL (nl. <120 mg/dL) C. Random blood glucose level of 300 mg/dL (nl. <200 mg/dL) D. Fasting blood glucose level of 48 mg/dL (nl. 60-110 mg/dL)

Correct Answer is C

Explanation

A. An HbA1c level of 7.5% indicates suboptimal long-term glucose control. The target for many diabetic patients is usually below 7%, but it may not require immediate action compared to more acute indicators.
B. A 2-hour post-prandial blood glucose level of 122 mg/dL is slightly above the normal range but not significantly high. This result alone is not as indicative of inadequate control as other values.
C. A random blood glucose level of 300 mg/dL is significantly elevated and indicates poor glucose control. This value is much higher than the normal range and suggests a need for further teaching and adjustment of diabetes management.
D. A fasting blood glucose level of 48 mg/dL is low and could indicate hypoglycemia rather than inadequate control. This level requires immediate attention but does not reflect poor long-term diabetes management.

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A nurse is caring for a 55-year-old client who requires antibiotic therapy. Exhibits A nurse is reviewing a client's medical record. Select the 4 findings that place the client at risk for hearing impairment.

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A nurse is caring for a 55-year-old client who requires antibiotic therapy.

Exhibits

A nurse is reviewing a client's medical record. Select the 4 findings that place the client at risk for hearing impairment.