A nurse is collecting data from a client who is taking dimenhydrinate to treat motion sickness. Which of the following findings is an adverse effect of this medication?

A. Drowsiness. Alendronate, a bisphosphonate used to treat osteoporosis, does not cause drowsiness. It primarily affects bone metabolism rather than the central nervous system. If a client experiences drowsiness, it is likely due to another cause rather than the medication itself.

B. Dyskinesia. Dyskinesia refers to involuntary movements often associated with neurological disorders or medications affecting dopamine, such as antipsychotics or Parkinson’s medications. Alendronate does not affect dopamine or the nervous system, making dyskinesia an unlikely adverse effect.

C. Musculoskeletal pain. A known side effect of alendronate is musculoskeletal pain, including bone, joint, and muscle discomfort. This occurs due to the medication’s effects on bone remodeling and turnover. While mild pain may resolve on its own, persistent or severe pain should be reported to the provider as it may require dose adjustment or discontinuation.

D. Weight gain. Alendronate does not cause weight gain. It primarily acts on bone tissue to inhibit osteoclast-mediated bone resorption, preventing further bone loss. Clients experiencing unexplained weight gain should be evaluated for other potential causes, such as metabolic conditions or lifestyle factors.

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.