The nurse is administering the sixth IV dose of gentamicin to a client with extensive full thickness burns. Which assessment finding warrants further intervention?
Reference Range:
White Blood Cell [5000 to 10,000/mm3 (5 to 10 x 10 %/L)] Blood Urea Nitrogen [10 to 20 mg/dL (3.6 to 7.1 mmol/L)] Creatinine [0.5 to 1.1 mg/dL (44 to 97 µmol/L)]
Serum creatinine level of 1.6 mg/l. (141 µmol), a blood urea nitrogen (BUN) of 20 mg/dL.(7.1 mmol/L)
Reports a sore mouth and three episodes of diarrhea that began this morning.
White blood count of 9,000/mm3 (9 x 109/L) and an oral temperature of 98.2° F (36.7° C) two hours ago.
Urinary output of 400 ml of clear, amber colored urine in the past eight hours.
The Correct Answer is A
A. Serum creatinine level of 1.6 mg/dL (141 µmol/L), a blood urea nitrogen (BUN) of 20 mg/dL (7.1 mmol/L): Gentamicin is an aminoglycoside that is known for its nephrotoxic potential. Elevated serum creatinine and BUN levels are indicative of impaired kidney function, which warrants further investigation and possible intervention. This finding is significant because it may reflect kidney damage or reduced renal clearance of the drug.
B. Reports a sore mouth and three episodes of diarrhea that began this morning: While these symptoms are important and could suggest a possible adverse effect or secondary infection, they are not as immediately concerning in the context of gentamicin therapy as the potential for kidney damage indicated by elevated creatinine and BUN levels.
C. White blood count of 9,000/mm³ (9 x 10^9/L) and an oral temperature of 98.2°F (36.7°C) two hours ago: These values are within normal ranges and do not suggest an immediate concern related to gentamicin toxicity.
D. Urinary output of 400 mL of clear, amber-colored urine in the past eight hours: While monitoring urinary output is important, this level of output does not necessarily indicate a problem in the context of gentamicin therapy compared to elevated creatinine and BUN levels.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. I should use this medication in its hand inhaler every day.: Tiotropium is a long-acting anticholinergic medication used for managing COPD, and it should be used daily, even if symptoms are not present. This statement indicates that the client understands the need for consistent daily use of the medication to manage COPD effectively.
B. When I cough up sputum, the secretions should be less thick.: Tiotropium is not specifically aimed at changing the thickness of sputum. It primarily works to open the airways, so while it may help with overall symptoms, it doesn't directly affect sputum viscosity.
C. I will use my other inhaler in between uses.: Tiotropium is usually prescribed for regular use as part of a long-term management plan, and the client may have other inhalers for different purposes (e.g., rescue inhalers for acute symptoms). However, the statement about using another inhaler in between uses may not be specific to the proper use of tiotropium itself.
D. If I have sudden shortness of breath, I will use this inhaler.: Tiotropium is a long-acting inhaled medication meant for maintenance therapy and is not intended for immediate relief of acute symptoms. For sudden shortness of breath, a rescue inhaler (usually containing a short-acting bronchodilator) would be more appropriate.
Correct Answer is C
Explanation
A. Warfarin: Warfarin is an oral anticoagulant used for long-term anticoagulation, but it is not used for reversing the effects of heparin. They are different classes of anticoagulants with distinct reversal agents.
B. Vitamin K: Vitamin K is used to reverse the effects of warfarin, not heparin.
C. Protamine sulfate: Protamine sulfate is the specific antidote for heparin overdose. It neutralizes the effects of heparin and is used to quickly reverse its anticoagulant effects in case of an overdose or excessive bleeding.
D. Diphenhydramine HCl: Diphenhydramine is an antihistamine and has no role in reversing anticoagulants.
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