A patient with diabetes who has bacterial pneumonia is being treated with IV gentamicin. What should the nurse monitor for adverse effects of the medication?
Serum creatinine
Urine osmolality
Blood glucose
Serum potassium
The Correct Answer is A
A. Serum creatinine: Gentamicin is nephrotoxic and can cause acute kidney injury. Monitoring serum creatinine provides early detection of renal impairment, which is a serious adverse effect of aminoglycosides.
B. Urine osmolality: While changes in urine concentration may occur with renal problems, it is not the most sensitive or routine measure for detecting gentamicin toxicity compared to serum creatinine.
C. Blood glucose: This must be monitored in diabetes, but it is unrelated to gentamicin toxicity. Altered glucose levels are not a direct adverse effect of aminoglycoside therapy.
D. Serum potassium: Gentamicin does not typically cause significant electrolyte disturbances like hyperkalemia or hypokalemia. Electrolyte monitoring is important in renal disease, but creatinine remains the primary marker of drug toxicity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Asking the patient to empty the bladder completely and then collecting the next specimen is not specific enough for a clean-catch technique. This method does not reduce contamination from the urethral meatus or surrounding genital area.
B. Using povidone iodine is not recommended for routine clean-catch urine collection because it can irritate the urethral area and does not offer additional benefit over standard cleansing with mild soap and water or antiseptic wipes.
C. Cleaning the urethral area reduces contamination, and discarding the initial urine flushes out bacteria from the urethra. Collecting midstream urine ensures that the sample accurately reflects bladder contents for culture and sensitivity testing.
D. Catheterization is an invasive procedure and is reserved for patients who cannot provide a clean-catch specimen. Routine midstream collection is preferred to reduce infection risk and discomfort while still providing an uncontaminated sample.
Correct Answer is D
Explanation
A. Protruding eyeballs: Proptosis or bulging eyes is not associated with dehydration. This finding is more commonly related to conditions such as thyroid eye disease or orbital tumors and does not indicate fluid deficit in older adults.
B. Hypothermia: Dehydration typically does not cause hypothermia. Older adults may have altered thermoregulation, but dehydration more commonly presents with other signs such as tachycardia, hypotension, or dry mucous membranes rather than low body temperature.
C. Elevated blood pressure: Dehydration usually leads to decreased circulating volume, which often results in hypotension rather than hypertension. Elevated blood pressure is not a typical expected finding in fluid-deficient states.
D. Furrows in the tongue: Dry mouth and deep furrows on the tongue are classic signs of dehydration. Reduced fluid intake or excessive fluid loss causes mucous membranes to become dry, and the tongue may appear cracked or furrowed.
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