A nurse is collecting data from a client who has pyelonephritis and receiving gentamicin via IV infusion. Which of the following manifestation should the nurse identify as an adverse effect of the treatment?

Slurred speech

Constipation

Hypotension

New onset of hearing loss

Answer and Explanation

The Correct Answer is D

A) Slurred speech:
Slurred speech is not a common adverse effect of gentamicin. It could indicate neurological issues, but it is not typically associated with gentamicin use. If this occurs, the nurse should investigate other possible causes, such as a stroke or another neurological condition, rather than attributing it to the gentamicin.

B) Constipation:
Constipation is not a typical adverse effect of gentamicin. While antibiotics can sometimes cause gastrointestinal disturbances, gentamicin is more commonly associated with nephrotoxicity and ototoxicity, rather than constipation. If constipation occurs, it is more likely related to other factors such as diet or fluid intake.

C) Hypotension:
While hypotension can be a side effect of many medications, it is not a specific or common adverse effect of gentamicin. Gentamicin is more likely to cause nephrotoxicity and ototoxicity rather than significant blood pressure changes. However, hypotension could occur in the context of an infection or severe illness and should be monitored, but it is not directly associated with gentamicin.

D) New onset of hearing loss:
This is a well-known adverse effect of gentamicin. Gentamicin belongs to the class of antibiotics known as aminoglycosides, which can cause ototoxicity. New onset of hearing loss or tinnitus (ringing in the ears) is a significant warning sign of ototoxicity, which can occur due to gentamicin use. This side effect should be monitored closely, and if hearing loss occurs, the medication should be reevaluated, and alternatives should be considered.

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Correct Answer is D

Explanation

A) Rubella titer nonimmune: A nonimmune rubella titer indicates that the client is not immune to rubella, which is a common finding in many pregnant women. However, rubella vaccination is not given during pregnancy because the vaccine is a live virus. The client will typically be vaccinated postpartum. Follow-up would be required, but it is not an urgent concern during the pregnancy itself.

B) Negative varicella titer: A negative varicella titer means the client is not immune to chickenpox, which is a concern because varicella can cause serious complications during pregnancy. However, similar to rubella, the varicella vaccine is contraindicated during pregnancy, and vaccination would be given postpartum. This requires follow-up after delivery but does not require urgent intervention during the pregnancy.

C) Positive Rh factor: The Rh factor is a blood type characteristic, but what is typically more concerning is the Rh incompatibility, which occurs when a Rh-negative mother carries a Rh-positive baby. A positive Rh factor is not a problem for the client themselves but could be important if the father is Rh-positive. If there is concern for Rh incompatibility, the nurse would monitor for the development of Rh sensitization and administer Rh immunoglobulin (RhoGAM) if needed. This does not require urgent intervention unless Rh incompatibility is confirmed.

D) Positive serologic test for syphilis: A positive test for syphilis requires immediate follow-up intervention. Syphilis is a sexually transmitted infection that can cause serious complications during pregnancy, including miscarriage, stillbirth, preterm birth, and congenital syphilis. Treatment with penicillin is recommended to prevent transmission to the baby and to treat the infection in the mother. A positive serologic test for syphilis warrants prompt intervention.

A. NG tube B. Tongue blade C. Suction machine D. Syringe containing lorazepam

Correct Answer is C

Explanation

A) NG tube: A nasogastric (NG) tube is not typically required for a client with a seizure disorder unless they have specific feeding or aspiration concerns that require tube feeding. During a seizure, the priority is to ensure airway clearance and prevent injury, not necessarily to provide nutrition through an NG tube.

B) Tongue blade: It is a common myth that tongue blades should be used to prevent a client from biting their tongue during a seizure. However, using a tongue blade can be dangerous as it can cause injury to the mouth or teeth, or even cause choking. The nurse should never attempt to place anything in the client's mouth during a seizure.

C) Suction machine: A suction machine is essential for maintaining airway patency during or after a seizure. Clients with seizure disorders may be at risk for aspiration, and the suction machine can be used to clear secretions from the mouth to prevent choking or aspiration pneumonia. This is the most appropriate supply to place at the bedside.

D) Syringe containing lorazepam: While lorazepam (a benzodiazepine) is sometimes used for acute seizure management, it is not a routine item to have immediately at the bedside unless specifically ordered for emergency seizure intervention. The nurse should follow protocol and administer medications as prescribed, but a syringe of lorazepam is not typically pre-placed at the bedside.

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A nurse is collecting data from a client who has pyelonephritis and receiving gentamicin via IV infusion. Which of the following manifestation should the nurse identify as an adverse effect of the treatment?

Nursing Test Bank

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