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?

A. Inadequate nutrition: Clients with nephrotic syndrome can experience protein loss in the urine leading to malnutrition, but the presence of ascites and 4+ leg edema directly indicates fluid retention rather than poor nutrition alone.

B. Poor perfusion: Poor perfusion is associated with signs such as hypotension, weak pulses, or cool extremities. While edema can impair tissue oxygenation to some extent, the primary problem here is not circulatory perfusion but excessive fluid accumulation.

C. Activity intolerance: Activity intolerance may develop secondarily due to discomfort from edema and ascites, but it is not the central issue reflected in the assessment findings. The immediate problem is fluid overload causing the visible physical changes.

D. Excess fluid volume: The hallmark signs of nephrotic syndrome include severe edema and ascites caused by low serum albumin and fluid shifting into interstitial spaces. These findings clearly demonstrate fluid retention, making excess fluid volume the primary patient problem.

A. Bradycardia: Tamsulosin, an alpha-1 adrenergic blocker, does not typically cause bradycardia. Its primary cardiovascular effects involve vasodilation, which may lead to hypotension or dizziness rather than slowing of the heart rate.

B. Temporary loss of libido: Changes in libido are not commonly associated with tamsulosin. While sexual side effects are possible with some medications for urinary symptoms, tamsulosin mainly affects smooth muscle tone in the prostate and bladder neck.

C. Burning with urination: Burning or dysuria is not a typical adverse effect of tamsulosin. If present, it may indicate another issue, such as infection or irritation from the cystoscopy procedure, rather than a direct effect of the medication.

D. Dizziness: Dizziness is a common adverse effect of tamsulosin due to its action on blood vessels, which can cause orthostatic hypotension. Clients should be advised to rise slowly from sitting or lying positions to minimize the risk of falls.