The nurse is caring for a client receiving gentamycin IV. Which of the following adverse effects would the nurse report to the physician immediately?
Ototoxicity
Nausea
Constipation
Increased urinary output
The Correct Answer is A
A. Ototoxicity:
Ototoxicity refers to damage to the auditory and vestibular nerves, leading to hearing loss and balance disturbances. Gentamicin, being an aminoglycoside antibiotic, is known for its potential to cause ototoxicity. Signs and symptoms of ototoxicity include changes in hearing, ringing in the ears (tinnitus), and imbalance. Ototoxicity is irreversible and can occur suddenly or gradually during gentamicin therapy. Therefore, any signs or symptoms of ototoxicity should be reported immediately to the physician for further evaluation and management.
B. Nausea:
Nausea is a common gastrointestinal side effect associated with gentamicin therapy. While it can be bothersome to the patient, nausea alone is not typically considered a severe adverse effect that requires immediate reporting to the physician. However, if nausea is severe or persistent and leads to dehydration or electrolyte imbalances, it should be addressed promptly.
C. Constipation:
Constipation is another potential gastrointestinal side effect of gentamicin therapy. Like nausea, constipation alone is not typically considered a severe adverse effect that requires immediate reporting to the physician. However, if constipation is severe or persistent and leads to discomfort or bowel obstruction, it should be addressed promptly.
D. Increased urinary output:
Increased urinary output may indicate improved renal function, which can be a desired effect during gentamicin therapy. Gentamicin is primarily excreted by the kidneys, and increased urinary output may help in the elimination of the drug from the body. Therefore, increased urinary output alone is not typically considered an adverse effect that requires immediate reporting to the physician. However, if there are signs of dehydration or electrolyte imbalances associated with increased urinary output, they should be addressed promptly.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Substance that can inhibit the growth of bacteria:
This definition is incorrect. The term "virulence" does not refer to a substance that inhibits bacterial growth. Instead, it pertains to the ability of a microorganism to cause disease.
B. Permanent, inheritable changes to DNA:
This definition is incorrect. Permanent, inheritable changes to DNA are typically referred to as mutations. While mutations can impact the characteristics of microorganisms, the term "virulence" specifically relates to disease-causing ability rather than genetic changes.
C. When a microbe is no longer affected by a drug following treatment with anti-infectives:
This definition is incorrect. The phenomenon described here is known as drug resistance or antimicrobial resistance. It refers to the ability of microorganisms to survive and multiply in the presence of antimicrobial agents, rendering the drugs ineffective.
D. The severity of disease that an organism is able to cause:
This definition is correct. Virulence refers to the degree or severity of disease that an organism, such as a bacterium or virus, is capable of causing. Microorganisms with high virulence can cause severe illness or death in infected hosts, while those with low virulence may cause milder symptoms or no symptoms at all.
Correct Answer is A
Explanation
A. She only has one functioning kidney:
This choice is the most significant consideration when prescribing vancomycin to Mrs. Oza. Vancomycin is primarily eliminated from the body through the kidneys. Individuals with reduced kidney function, such as Mrs. Oza with only one functioning kidney, have a higher risk of vancomycin-associated nephrotoxicity (kidney damage). Therefore, her renal status is crucial information for determining the appropriate dosage of vancomycin and monitoring for any signs of kidney impairment during treatment.
B. She remains outdoors for long periods of time:
While spending time outdoors for long periods may have implications for Mrs. Oza's overall health, it is not directly relevant to the prescription of vancomycin. This information may be important for considering sun exposure, hydration, and other factors related to her arthritis and general well-being, but it does not specifically impact the pharmacokinetics or pharmacodynamics of vancomycin.
C. She has hypertension:
Mrs. Oza's hypertension is a relevant medical condition to consider in her overall health management. However, hypertension alone does not directly affect the prescription of vancomycin. Hypertension may influence the choice of antihypertensive medications or other aspects of her medical care, but it does not have a direct impact on the renal clearance or potential nephrotoxicity of vancomycin.
D. She enjoys an alcoholic beverage twice a week:
While alcohol consumption can interact with certain medications and impact overall health, it is not the most significant consideration when prescribing vancomycin to Mrs. Oza. Moderate alcohol consumption is unlikely to directly affect the pharmacokinetics or pharmacodynamics of vancomycin. However, excessive alcohol intake may contribute to liver dysfunction, which could indirectly influence drug metabolism. Nonetheless, in Mrs. Oza's case, her reduced renal function is a more critical factor to consider when prescribing vancomycin.
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