The nurse is caring for a 70-kg patient who is receiving ...

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The nurse is caring for a 70-kg patient who is receiving gentamicin (Garamycin) 85 mg 4 times daily. The patient reports experiencing ringing in the ears. The nurse will contact the provider to discuss
 
  a. decreasing the dose to 50 mg QID.
  b. giving the dose 3 times daily.
  c. obtaining a serum drug level.
  d. ordering a hearing test.

Question 2

The nurse is providing discharge teaching for a patient who will receive oral levofloxacin (Levaquin) to treat pneumonia.
 
  The patient takes an oral hypoglycemic medication and uses over-the-counter (OTC) antacids to treat occasional heartburn. The patient reports frequent arthritis pain and takes acetaminophen when needed. Which statement by the nurse is correct when teaching this patient?
  a. You may take antacids with levofloxacin to decrease gastrointestinal upset.
  b. You may take nonsteroidal anti-inflammatory medications (NSAIDs) for arthritis pain.
  c. You should monitor your serum glucose more closely while taking levofloxacin.
  d. You should take levofloxacin on an empty stomach to improve absorption.

[elyse44]

Answer to Question 1

ANS: C
Aminoglycosides can cause ototoxicity. Any changes in hearing should be reported to the provider so that serum drug levels can be monitored. The dose is correct for this patient's weight (5 mg/kg/day in 4 divided doses). A hearing test is not indicated unless changes in hearing persist.

Answer to Question 2

ANS: C
Levofloxacin may increase the effects of oral hypoglycemic medications, so patients taking these should be advised to monitor their serum glucose levels closely. Antacids decrease the absorption of levofloxacin. NSAIDs taken with levofloxacin can cause central nervous system reactions, including seizures.

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