Which interventions would the nurse perform before administering the next dose of gentamicin to an older adult client?
1. Monitor for peak and trough for toxicity.
2. Check the health care provider's orders for periodic lab draws.
3. Contact the health care provider if serum concentration is not within therapeutic range.
4. Check that this drug is prescribed with short intervals between doses.
5. Assess client for reduced cognitive function or confusion.
Correct Answer: 1,2,3
Rationale 1: Age-related changes result in a decrease in total body water in the older adult. Because gentamicin is water soluble, this could result in higher concentration of the drug, causing toxicity.
Rationale 2: To prevent toxicity of gentamicin, periodic lab work for peak and trough must be checked.
Rationale 3: If the serum concentration is not within therapeutic range, the dose may need to be adjusted.
Rationale 4: Drugs with a long half-life have the potential to accumulate in the tissues. These drugs should be prescribed with longer intervals between doses.
Rationale 5: Gentamicin toxicity symptoms include impaired hearing, not reduced cognitive function or confusion.
Global Rationale: Age-related changes result in a decrease in total body water in the older adult. Because gentamicin is water soluble, this could result in higher concentration of the drug, causing toxicity. To prevent toxicity of gentamicin, periodic lab work for peak and trough must be checked. If the serum concentration is not within therapeutic range, the dose may need to be adjusted. Drugs with a long half-life have the potential to accumulate in the tissues. These drugs should be prescribed with longer intervals between doses. Gentamicin toxicity symptoms include impaired hearing, not reduced cognitive function or confusion.
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