The nurse is admitting to the unit a patient who has just had a ...

[kamilo84]

The nurse is admitting to the unit a patient who has just had a minor operation and received a general anesthetic. The nurse notices that gentamicin (Garamycin) is infusing IV.
 
  Which of the following clinical findings associated with these drug-drug interactions would most alarm the nurse?
  a. Diluted urine
  b. Decreased sensation in the lower extremities
  c. Hyperreflexia
  d. Persistent headache

Question 2

A 68-year-old patient is receiving an aminoglycoside IV for a serious infection. The patient develops heart failure and needs a diuretic. Which medication order would cause the nurse the most concern?
 
  a. Ethacrynic acid (Edecrin)
  b. Hydrochlorothiazide (HCTZ)
  c. Furosemide (Lasix)
  d. Bumetanide (Bumex)

[Sophiapenny]

Answer to Question 1

ANS: B
Neuromuscular blockade may occur after IV, intramuscular (IM), and oral administration of gentamicin. The risk of paralysis is increased by concurrent use of neuromuscular blocking agents and general anesthetics. Decreased sensation in the lower extremities may signal paralysis.
Diluted urine is not an effect of drug-drug interactions.
Hyperreflexia would not be anticipated, nor would persistent headache, which might be seen with ototoxicity related to concurrent administration of other ototoxic medications.

Answer to Question 2

ANS: A
The risk of injury to the inner ear is significantly increased by concurrent use of an aminoglycoside and ethacrynic acid, which has ototoxic actions of its own.
Hydrochlorothiazide is not known to have a drug-drug interaction with aminoglycosides, just the loop diuretics.
Combining furosemide and bumetanide with the aminoglycosides appears to cause no more ototoxicity than aminoglycosides alone.

[kamilo84]

TYSM

[tkempin]

Excellent