A patient is receiving gentamicin once daily. A nursing student ...

[daltonest1984]

A patient is receiving gentamicin once daily. A nursing student asks the nurse how the drug can be effective if given only once a day. The nurse explains drug dosing schedules for aminoglycosides.
 
  Which statement by the student indicates a need for further teaching?
  a. Gentamicin has a longer half-life than other aminoglycosides.
  b. Large doses given once daily yield higher peak levels.
  c. The postantibiotic effect lasts for several hours.
  d. There is less risk of ototoxicity and nephrotoxicity with large daily doses.

Question 2

A patient who has been taking gentamicin for 5 days reports a headache and dizziness. What will the nurse do?
 
  a. Request an order for a gentamicin peak level.
  b. Suspect ototoxicity and notify the prescriber.
  c. Tell the patient to ask for help with ambulation.
  d. Tell the patient to report any tinnitus.

[l.stuut]

Answer to Question 1

ANS: A
When a daily dose is given once daily instead of divided into 2 or 3 doses, a higher peak level can be achieved. The higher peak, along with the fact that aminoglycosides have a postantibiotic effect, means that the bacterial kill is just as great with one dose as with 2 or 3 doses per day. When a single daily dose is given, the risk of toxicity is reduced. Gentamicin does not have a longer half-life than other aminoglycosides.

Answer to Question 2

ANS: B
Headache and dizziness are signs of ototoxicity, and the prescriber should be notified. A peak level is not indicated; it is more important to know the trough level. Telling the patient to ask for help with ambulation and to report tinnitus should both be done but are not the priority nursing action.

[daltonest1984]

Excellent

[ghepp]

TYSM