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. Take phenazopyridine for at least 7 days: Phenazopyridine is a urinary analgesic and does not treat the underlying infection. It should be used only for symptom relief, usually for a short duration, and not as a substitute for the full course of antibiotics.
B. Phenazopyridine may cause photosensitivity: Photosensitivity is not a commonly reported side effect of phenazopyridine. The primary concern with this medication relates to its effects on urine color rather than skin sensitivity to sunlight.
C. Phenazopyridine may change the urine color: Phenazopyridine can turn urine a reddish-orange color, which is harmless but important for patients to understand to avoid alarm. Educating the patient about this expected effect improves adherence and reduces anxiety related to urine discoloration.
D. Take phenazopyridine before sexual course: Phenazopyridine is not indicated as a preventative or prophylactic measure for sexual activity. Its use is for symptomatic relief of urinary discomfort and should be coordinated with the prescribed antibiotic regimen.
Correct Answer is C
Explanation
A. Compare blood pressures in the left and right arms: Blood pressure should never be measured in the arm with an arteriovenous fistula because the pressure from the cuff can damage the access site and compromise patency.
B. Assess the quality of the left radial pulse: While radial pulse assessment provides information about peripheral circulation, it does not specifically evaluate fistula function. The patency of a fistula is best assessed directly at the site rather than by distal pulses.
C. Auscultate for a bruit at the fistula site: The presence of a bruit, along with palpating a thrill, is the most reliable way to confirm that the arteriovenous fistula is patent and functioning. Regular assessment helps detect complications such as thrombosis or stenosis.
D. Irrigate the fistula site with saline every 8 to 12 hours: Irrigating or flushing the fistula is not an appropriate nursing action. Invasive manipulation can damage the site, increase infection risk, and jeopardize vascular access, which is essential for hemodialysis treatment.
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