A peak and trough level was obtained from a client receiving an aminoglycoside IV every 8 hours. Which finding presents the highest risk for the client and should be reported immediately to the healthcare provider?

Decreased peak, decreased trough.

Decreased trough only.

Increased peak, increased trough.

Decreased peak only.

Answer and Explanation

The Correct Answer is C

A) A decreased peak and trough level may indicate subtherapeutic levels of the medication but do not pose an immediate risk to the client. Adjustments to the dosing regimen may be needed, but this finding does not require immediate action.

B) A decreased trough level alone may suggest a need for dosage adjustment but does not present an immediate risk to the client. It is important to monitor therapeutic drug levels, but this finding does not require immediate reporting to the healthcare provider.

C) An increased peak and trough level indicates potential toxicity of the medication. Increased peak levels can lead to nephrotoxicity, while increased trough levels can lead to ototoxicity. Both conditions are serious and require immediate action to prevent harm to the client. The nurse should report this finding immediately to the healthcare provider for further evaluation and possible adjustment of the medication regimen.

D) A decreased peak level alone may indicate subtherapeutic levels of the medication, but it does not pose an immediate risk to the client. Adjustments to the dosing regimen may be needed, but this finding does not require immediate action.

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Correct Answer is B

Explanation

A) Decreased blood urea nitrogen (BUN) is not a typical adverse effect of gentamicin. Gentamicin is primarily associated with nephrotoxicity (kidney damage), which would manifest as an increased BUN and serum creatinine rather than a decrease.

B) Hearing loss is a well-known adverse effect of gentamicin, particularly when the drug reaches high concentrations in the inner ear (ototoxicity). Gentamicin can cause irreversible damage to the cochlear and vestibular organs, leading to sensorineural hearing loss and balance disturbances.

C) Reports of photophobia are not typically associated with gentamicin. Photophobia (sensitivity to light) may occur with certain eye conditions or central nervous system disorders but is not a direct adverse effect of gentamicin.

D) A white blood cell count of 6,000/mm3 falls within the normal reference range, so it does not indicate an adverse effect of gentamicin. Gentamicin is not known to directly affect white blood cell count.

A. Intolerance to cold. B. Constipation. C. Restlessness. D. Decreased appetite.

Correct Answer is C

Explanation

A) Intolerance to cold: Intolerance to cold is a common symptom of hypothyroidism, not a sign of taking too much levothyroxine sodium. Therefore, this symptom would not indicate an overdose of the medication.

B) Constipation: Constipation can be a symptom of hypothyroidism, and it may improve with appropriate thyroid hormone replacement therapy. It is not typically associated with taking too much levothyroxine sodium.

C) Restlessness: This is the correct answer. Restlessness, anxiety, nervousness, or feeling jittery are symptoms of hyperthyroidism, which can occur if the client is taking too much levothyroxine sodium. If the dose of levothyroxine is too high, it can lead to hyperthyroid symptoms, even though the medication is intended to treat hypothyroidism.

D) Decreased appetite: Decreased appetite is not a typical symptom of taking too much levothyroxine sodium. In fact, weight loss is more commonly associated with hyperthyroidism, which can occur if the dose of levothyroxine is too high. However, decreased appetite alone may not specifically indicate an overdose of levothyroxine.

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A peak and trough level was obtained from a client receiving an aminoglycoside IV every 8 hours. Which finding presents the highest risk for the client and should be reported immediately to the healthcare provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A male client has been receiving the antibiotic gentamicin sulfate, IV piggyback every 12 hours for several days. Which observation by the nurse indicates that the client may be experiencing an adverse effect of gentamicin? Reference Range: White Blood Cell [5000 to 10,000/mm3 (5 to 10 x 10%)]

Correct Answer is B

Explanation

Levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much levothyroxine sodium?

Correct Answer is C

Explanation

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A peak and trough level was obtained from a client receiving an aminoglycoside IV every 8 hours. Which finding presents the highest risk for the client and should be reported immediately to the healthcare provider?

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