The nurse reviews the client's test results.

Exhibits

For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the client.

A. New onset of hearing loss. Gentamicin is an aminoglycoside antibiotic known for its ototoxic effects, which can lead to irreversible hearing loss or vestibular dysfunction. The drug damages the hair cells in the inner ear, resulting in symptoms like tinnitus, dizziness, or difficulty hearing. Clients receiving gentamicin should be closely monitored for auditory changes, as early detection can help prevent worsening damage.
B. Constipation. Gentamicin does not typically affect gastrointestinal motility, making constipation an unlikely adverse effect. It primarily causes nephrotoxicity and ototoxicity, with its main targets being the kidneys and inner ear. Gastrointestinal side effects are rare and usually limited to nausea or mild discomfort rather than significant bowel irregularities.
C. Slurred speech. While aminoglycosides can cause neuromuscular blockade in rare cases, slurred speech is not a common adverse effect. More frequently, gentamicin affects the vestibular system, leading to balance disturbances or dizziness rather than impairing speech function. If neuromuscular symptoms develop, the medication should be reassessed to prevent severe complications.
D. Hypotension. Gentamicin does not directly cause hypotension as a primary side effect. Its adverse effects are more commonly associated with kidney damage, ototoxicity, and, in rare cases, neuromuscular paralysis. If a client on gentamicin experiences hypotension, other underlying causes such as sepsis or volume depletion should be considered.

A. "I should eat a high-fat diet for several weeks." After a laparoscopic cholecystectomy, clients are typically advised to follow a low-fat diet for several weeks to help their bodies adjust to the absence of the gallbladder. The gallbladder stores bile, which aids in the digestion of fats. Without it, a high-fat diet can lead to gastrointestinal discomfort, including cramping and diarrhea. Gradually reintroducing fats based on tolerance is recommended.
B. "I should expect to have diarrhea until my diet changes." While some clients may experience temporary diarrhea after surgery, it is not a universal side effect. Changes in bowel habits can occur due to alterations in bile flow, but not all clients will have diarrhea. Maintaining a balanced diet and gradually increasing fiber intake can help regulate bowel movements and minimize gastrointestinal disturbances.
C. "I should leave my steri-strips on until they fall off." Steri-strips, or adhesive strips used to secure the incision, should be left in place until they naturally fall off, which usually occurs within one to two weeks. Removing them prematurely can compromise the healing process and increase the risk of infection or wound dehiscence.
D. "I should expect to have nausea for several days." Nausea can occur after surgery due to anesthesia, but it should not persist for several days. While some postoperative nausea is normal, ongoing or severe nausea may indicate a complication, such as an adverse reaction to medication or an underlying issue, and should be communicated to the healthcare provider for further evaluation and management.