A patient who has been receiving intravenous gentamicin for ...

[WWatsford]

A patient who has been receiving intravenous gentamicin for several days reports having had a headache for 2 days. The nurse will request an order to:
 
  a. obtain a gentamicin trough before the next dose is given.
  b. give an analgesic to control headache discomfort.
  c. reduce the dose of the gentamicin to minimize side effects.
  d. obtain renal function tests to evaluate for potential nephrotoxicity.

Question 2

A patient is admitted to the unit for treatment for an infection. The patient receives IV amikacin (Amikin) twice a day. When planning for obtaining a peak aminoglycoside level, when should the nurse see that the blood is drawn?
 
  a. 30 minutes after the IV infusion is complete
  b. 1 hour after the IV infusion is complete
  c. 1 hour before administration of the IV infusion
  d. A peak level is not indicated with twice-daily dosing.

[xMRAZ]

Answer to Question 1

ANS: A
A headache may be a sign of developing ototoxicity, so a gentamicin trough should be obtained before the next dose is given. Analgesics are not indicated until a serious cause of the headache has been ruled out. Reducing the dose without first knowing the level would not be indicated. A headache is an early sign of ototoxicity, not nephrotoxicity.

Answer to Question 2

ANS: A
When divided daily doses are used, blood samples for measurement of peak levels are drawn 1 hour after IM injection and 30 minutes after completion of an IV infusion. This medication is administered IV, so blood draws must follow 30 minutes after infusion to obtain peak levels. Measurement of peak levels is unnecessary only when a single daily dose is used.

[WWatsford]

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[xMRAZ]

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