A nurse is caring for a client who is receiving tobramycin. The nurse should monitor the client for which of the following adverse effects?

Increased salivation

Bruising

joint pain

Tinnitus

Answer and Explanation

The Correct Answer is D

A. Increased salivation. Tobramycin, an aminoglycoside antibiotic, does not cause increased salivation. It primarily affects the kidneys and auditory system, with no significant impact on saliva production. Increased salivation is more commonly associated with medications affecting the autonomic nervous system, such as cholinergic agents.

B. Bruising. While some antibiotics may impact platelet function, aminoglycosides like tobramycin do not commonly cause thrombocytopenia or increased bruising. Clients experiencing unexplained bruising should be evaluated for other underlying causes, such as coagulation disorders or concurrent medication use.

C. Joint pain. Joint pain is not a typical adverse effect of tobramycin. While some antibiotics, like fluoroquinolones, are associated with tendonitis or joint issues, aminoglycosides primarily affect the kidneys and inner ear, leading to nephrotoxicity and ototoxicity rather than musculoskeletal symptoms.

D. Tinnitus. Tobramycin is ototoxic and can cause tinnitus, hearing loss, or balance disturbances due to its toxic effects on the auditory and vestibular nerves. Clients receiving tobramycin should be monitored for early signs of ototoxicity, and the medication should be discontinued if symptoms develop to prevent permanent hearing damage.

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Correct Answer is C

Explanation

A. "My appetite is increased." Diphenhydramine is an antihistamine that primarily treats allergic reactions by blocking histamine receptors. While antihistamines can sometimes cause increased appetite as a side effect, this is not an indicator of effectiveness in treating an allergic reaction.

B. "I don't have a headache anymore." While diphenhydramine may help with headaches due to its sedative and antihistamine effects, headache relief is not the primary goal when treating an allergic reaction. The effectiveness of diphenhydramine in this scenario should be assessed based on improvements in allergic symptoms rather than headache relief.

C. "My voice is no longer hoarse." Hoarseness can be a sign of airway involvement due to allergic reaction-related swelling (laryngeal edema). Diphenhydramine reduces histamine-induced inflammation, which can help resolve airway symptoms. Improvement in hoarseness suggests reduced swelling and a lower risk of airway obstruction, making this the best indicator of effectiveness.

D. "I am feeling more alert." Diphenhydramine commonly causes drowsiness due to its sedative effects. Feeling more alert would be an unusual response to the medication and does not indicate improvement in the allergic reaction. The primary concern is symptom resolution, particularly respiratory symptoms, rather than changes in alertness.

A. Hypertension B. Fluid retention C. Bone pain D. Hypokalemia

Correct Answer is C

Explanation

A. Hypertension. Filgrastim, a granulocyte colony-stimulating factor (G-CSF), primarily stimulates white blood cell production. While minor blood pressure fluctuations can occur, hypertension is not a common or significant adverse effect. Monitoring blood pressure is important, but sustained hypertension is not expected.

B. Fluid retention. Filgrastim does not typically cause significant fluid retention. Medications such as corticosteroids or certain chemotherapeutic agents are more likely to lead to fluid overload. While rare cases of capillary leak syndrome have been reported, general fluid retention is not a primary concern.

C. Bone pain. Bone pain is the most common adverse effect of filgrastim. The medication stimulates bone marrow activity, leading to increased production of neutrophils, which can cause discomfort in bones, particularly in long bones such as the femur and sternum. Pain is usually mild to moderate and can be managed with acetaminophen or NSAIDs if appropriate.

D. Hypokalemia. Filgrastim does not have a direct effect on potassium levels. Electrolyte imbalances are more commonly associated with diuretics, corticosteroids, or chemotherapy. Clients on filgrastim typically do not require routine potassium monitoring unless other risk factors are present.

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A nurse is caring for a client who is receiving tobramycin. The nurse should monitor the client for which of the following adverse effects?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who received diphenhydramine 1 hr ago after developing an allergic reaction to trimethoprim- sulfamethoxazole. Which of the following statements by the client should indicate to the nurse that the medication is effective?

Correct Answer is C

Explanation

A nurse is caring for a client who is receiving filgrastim. The nurse should monitor the client for which of the following adverse effects?

Correct Answer is C

Explanation

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