A nurse is caring for a patient receiving gentamicin sulfate, an Aminoglycoside antibiotic, for a severe bacterial infection. Which assessment finding should the nurse report immediately to the healthcare provider?

Decreased urine output

Mild nausea

Slightly elevated heart rate

Headache

Answer and Explanation

The Correct Answer is A

A. Decreased urine output.: A reduction in urine output is a critical finding because gentamicin is nephrotoxic and can cause acute kidney injury by damaging renal tubule cells. Early signs of nephrotoxicity include oliguria, increased serum creatinine, and elevated BUN levels.

B. Mild nausea.: Nausea is a relatively common and mild side effect of many antibiotics, including gentamicin. It does not usually indicate toxicity and can often be managed with supportive care or by adjusting administration timing.

C. Slightly elevated heart rate.: A mild increase in heart rate may occur due to infection, fever, or stress, but it is not directly linked to gentamicin toxicity. The nurse should continue to monitor vital signs but prioritize assessment of renal and auditory function.

D. Headache.: Headache can occur with antibiotic therapy or as a symptom of infection but is generally not an urgent finding. The primary toxicities are nephrotoxicity and ototoxicity, making renal assessment findings such as decreased urine output the highest priority.

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Correct Answer is B

Explanation

A. Ototoxicity.: Ototoxicity is more commonly associated with aminoglycosides such as gentamicin or vancomycin, not tetracyclines. These drugs can damage the auditory nerve, but tetracyclines do not affect hearing or balance mechanisms in the inner ear.

B. Tooth discoloration.: Tetracyclines can bind to calcium in developing teeth and bones, causing permanent yellow-gray or brown discoloration. This effect is especially concerning in children under 8 years old, whose teeth and bones are still forming, making the drug contraindicated for pediatric use unless absolutely necessary.

C. Nephrotoxicity.: Nephrotoxicity (kidney damage) can occur, especially with outdated tetracycline preparations or in patients with pre-existing renal issues, but it is not the primary reason for the drug's contraindication in children under 8 years old.

D. Hyperglycemia.: Tetracyclines have no known effect on blood glucose regulation. Hyperglycemia may occur with corticosteroids or certain antipsychotics but is not a recognized adverse reaction associated with tetracycline therapy.

A. Definitive therapy B. Empiric therapy C. Prophylactic therapу D. Palliative therapy

Correct Answer is A

Explanation

A. Definitive therapy.: Definitive therapy is initiated after the causative organism has been identified through culture and sensitivity testing. The provider selects an antibiotic specifically targeted to the known pathogen, ensuring optimal effectiveness and reducing the risk of antibiotic resistance.

B. Empiric therapy.: Empiric therapy refers to starting broad-spectrum antibiotics before the exact pathogen is identified, based on the most likely cause of infection. This is what the client initially received upon presentation with sepsis, before culture results were available.

C. Prophylactic therapy.: Prophylactic therapy involves administering antibiotics to prevent infection rather than treat an existing one. It is commonly used before surgical procedures or in immunocompromised clients at high risk for infection, not in active sepsis cases.

D. Palliative therapy.: Palliative therapy aims to relieve symptoms and improve comfort in clients with terminal or chronic conditions. It does not treat the underlying infection or alter disease progression.

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A nurse is caring for a patient receiving gentamicin sulfate, an Aminoglycoside antibiotic, for a severe bacterial infection. Which assessment finding should the nurse report immediately to the healthcare provider?

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