A nurse is reviewing a client's peak and trough levels of gentamicin. The peak should be 6 to 8 mcg/mL and the trough should be 0.5 to 1 mcg/mL. The client's peak is10 mcg/mL and his trough is 2.3 mcg/mL. Which of the following clinical manifestations should the nurse expect with these findings? (Select all that apply.)

Insomnia

Constipation

Xerostomia

Persistent headache

Tinnitus

Answer and Explanation

Correct Answer : D,E

D. Persistent headache can occur with elevated levels of gentamicin, as it may indicate neurotoxicity. Gentamicin can cause neurotoxic effects, including headaches, especially when levels are elevated.

E. Tinnitus (ringing in the ears) is a classic symptom of gentamicin toxicity. Elevated gentamicin levels can lead to ototoxicity, which manifests as tinnitus among other auditory symptoms.

A. Insomnia is not typically associated with elevated levels of gentamicin. Elevated gentamicin levels are not known to cause insomnia.

B. Constipation is not typically associated with elevated levels of gentamicin. Elevated gentamicin levels are not known to cause constipation.

C. Xerostomia (dry mouth) is not typically associated with elevated levels of gentamicin. Elevated gentamicin levels are not known to cause xerostomia.

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Correct Answer is B

Explanation

B. Dextrose 10% in water is a solution that contains a high concentration of glucose (dextrose). Infusing D10W can lead to an increase in blood glucose levels, especially if the client's body cannot metabolize the glucose effectively (e.g., in diabetic patients or those with impaired glucose tolerance).

A. Dextrose 10% in water does not contain calcium. Hypercalcemia refers to elevated calcium levels in the blood, which can occur due to various causes such as hyperparathyroidism or excessive vitamin D intake, but not from D10W infusion.

C. Dextrose 10% in water is not used to treat hypovolemia (low blood volume). It is a solution primarily used to provide calories and prevent ketosis rather than to expand circulating blood volume.

D. Dextrose 10% in water does not contain potassium. Hypokalemia (low potassium levels) can occur due to various reasons such as diuretic use, gastrointestinal losses, or inadequate intake, but it is not directly related to D10W infusion.

A. Ensure the client's IV solution is changed every 48 hr B. Check the client's IV site every 8 hr. C. Change the client's IV tubing every 96 hr. D. Replace the client's transparent IV dressing every 24 hr.

Correct Answer is A

Explanation

A. IV solutions and administration sets should typically be changed every 48 to 72 hours to reduce the risk of contamination and infection. This interval helps prevent the buildup of bacteria in the solution and tubing, which could lead to bloodstream infections (BSIs).

B. Checking the client's IV site every is also important for monitoring for signs of infection, infiltration, or phlebitis. However, every 8 hours is too frequent and unnecessary

C. IV tubing should be changed every 72 hours not every 96 hours. Prolonging the use of IV tubing beyond this timeframe increases the risk of bacterial contamination and infection.

D. Transparent dressings are usually changed every 5 to 7 days, or sooner if they become soiled or compromised.

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Naxlex Comprehensive Predictor Exams

A nurse is assisting with the care of a client who is receiving an IV infusion of dextrose 10% in water. The nurse should monitor the client for which of the following adverse effects?

Correct Answer is B

Explanation

A nurse is caring for a client who is receiving a continuous IV infusion through a short-peripheral device. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

For a patient who is experiencing an ECV excess, the nurse plans to determine the fluid status. The best way for the nurse to determine the fluid balance for the patient is to:

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The IV site of a patient receiving a continuous IV infusion should be monitored by the nurse:

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