Which of the following patients is at the greatest risk of developing acute kidney injury? A patient who:
a. has been on aminoglycosides for the past 6 days.
b. has a history of controlled hypertension with a blood pressure of 138/88 mm Hg.
c. was discharged 2 weeks earlier after aminoglycoside therapy of 2 weeks.
d. has a history of fluid overload as a result of heart failure.
C
Acute kidney injury can be caused by aminoglycoside nephrotoxicity, especially prolonged use of the drug (more than 10 days). Symptoms of acute kidney injury are usually seen about 1 to 2 weeks after exposure. Because of this delay, the patient must be questioned about any recent medical therapy for which an aminoglycoside may have been prescribed. The blood pressure of 138/88 mm Hg controlled by medication would not cause acute kidney injury, nor would fluid overload from exacerbation of heart failure.
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