Which of the following complaints by a man taking gentamycin would be most indicative that he is experiencing ototoxicity?
changes in mental status
complaints that he is unable to hear the television
an increase in the BUN and creatinine
tingling of the extremities
The Correct Answer is B
A. Changes in mental status:
Changes in mental status are not typically associated with ototoxicity caused by gentamicin. Mental status changes may indicate other systemic effects or adverse reactions, but they are not specific to ototoxicity.
B. Complaints that he is unable to hear the television:
This complaint is highly indicative of ototoxicity. Hearing loss, particularly high-frequency hearing loss, is a common symptom of ototoxicity caused by drugs like gentamicin. Difficulty hearing sounds such as the television, especially at typical volume levels, suggests a potential problem with hearing function.
C. An increase in the BUN and creatinine:
An increase in blood urea nitrogen (BUN) and creatinine levels may indicate kidney damage, which can occur as a result of nephrotoxicity associated with gentamicin use. While nephrotoxicity is a known adverse effect of gentamicin, it is not specific to ototoxicity.
D. Tingling of the extremities:
Tingling of the extremities is not typically associated with ototoxicity caused by gentamicin. This symptom may suggest other neurological or systemic effects but is not specific to ototoxicity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Antibiotic dosages below the minimum concentration are prescribed:
This statement is incorrect. When treating MRSA infections, it's essential to prescribe antibiotic dosages that achieve adequate concentrations to effectively combat the resistant bacteria. Suboptimal dosages or inadequate duration of treatment can contribute to treatment failure and the development of antibiotic resistance. Therefore, the nurse should emphasize the importance of prescribing appropriate dosages of antibiotics for MRSA infections.
B. Broad-spectrum antibiotics are used whenever possible:
This statement is not accurate. While broad-spectrum antibiotics may be effective against a wide range of bacteria, they are not always the preferred choice for treating MRSA infections. MRSA is resistant to many antibiotics, including those commonly used as broad-spectrum agents. Therefore, the treatment of MRSA typically involves antibiotics that are specifically effective against this resistant strain, such as vancomycin, daptomycin, linezolid, or other agents based on susceptibility testing. Therefore, the nurse should educate the client that specific antibiotics effective against MRSA are used, rather than relying solely on broad-spectrum antibiotics.
C. Antibiotics are prescribed only when a viral infection is present:
This statement is incorrect. Antibiotics are not effective against viral infections, including those caused by viruses such as influenza or the common cold. MRSA is a bacterial infection, and antibiotics are indicated for its treatment. However, it's essential to use antibiotics judiciously and only when necessary to avoid contributing to antibiotic resistance. The nurse should educate the client that antibiotics are prescribed for bacterial infections like MRSA, but they are not appropriate for viral infections.
D. Infections become resistant to high doses of antibiotics:
This statement is accurate. Overuse or inappropriate use of antibiotics, including high doses, can contribute to the development of antibiotic resistance. Bacteria like MRSA can acquire resistance mechanisms that render antibiotics ineffective, even at high doses. Therefore, it's crucial to use antibiotics judiciously, following appropriate dosing guidelines and duration of treatment, to minimize the risk of antibiotic resistance. The nurse should include this information in the teaching to emphasize the importance of responsible antibiotic use in the management of MRSA infections.
Correct Answer is B
Explanation
A. Decision to administer either a bactericidal or bacteriostatic drug:
Culture and sensitivity tests provide information about the susceptibility of the microorganism to specific antimicrobial agents. Based on this information, healthcare providers can choose between bactericidal (agents that kill bacteria) or bacteriostatic (agents that inhibit bacterial growth) drugs. For example, if the culture indicates that the microorganism is susceptible to a bactericidal drug, such as penicillin, the healthcare provider may choose to administer that type of drug.
B. Microbial susceptibility to an anti-infective:
This option accurately describes one of the primary purposes of culture and sensitivity tests. These tests determine whether the microorganism causing the infection is susceptible or resistant to specific antimicrobial agents. This information guides the selection of the most appropriate anti-infective therapy to effectively treat the infection.
C. Duration of the antibacterial drug therapy:
While culture and sensitivity tests provide valuable information about microbial susceptibility to antimicrobial agents, they do not specifically determine the duration of antibacterial drug therapy. The duration of therapy is often determined based on factors such as the type and severity of the infection, the patient's response to treatment, and clinical guidelines, rather than solely on the results of culture and sensitivity tests.
D. Decision to administer empiric therapy:
Empiric therapy involves the initiation of antimicrobial treatment based on clinical judgment and knowledge of likely pathogens before culture and sensitivity results are available. Culture and sensitivity tests help confirm the causative microorganism and guide subsequent treatment decisions, including adjustments to therapy based on the results. Therefore, while culture and sensitivity tests inform decisions regarding antimicrobial therapy, they do not directly determine whether empiric therapy should be initiated.
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