A patient who takes the loop diuretic ethacrynic acid is given intravenous gentamicin for an infection
After several days of treatment with gentamicin, the nurse reviews the patient's most recent laboratory results and notes a gentamicin trough of 2.1 mcg/mL and normal blood urea nitrogen (BUN) and serum creatinine levels. The nurse will question the patient about: a. gastrointestinal (GI) symptoms.
b. headache, dizziness, or vertigo.
c. presence of rash.
d. urine output.
B
Ethacrynic acid has ototoxic properties, and patients who take this drug with an aminoglycoside have an increased risk of ototoxicity, especially when trough levels of the aminoglycoside are elevated. A trough level of 2.1 mcg/mL is above normal limits for gentamicin, so this patient should be asked about early signs of ototoxicity. There is no indication to evaluate for GI symp-toms, rash, or urine output.
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