Nalidixic acid (NegGram) is prescribed for a client with a urinary tract infection. On review of the client's record, the nurse notes that the client is taking warfarin sodium (Coumadin) daily. Which prescription should the nurse anticipate for this client?

Correct Answer: B

Rationale: Nalidixic acid can intensify the effects of oral anticoagulants by displacing these agents from binding sites on plasma proteins. When an oral anticoagulant, like warfarin sodium (Coumadin), is combined with nalidixic acid, a decrease in the anticoagulant dosage may be necessary to avoid excessive anticoagulation and potential bleeding risks.

Correct Answer: A

Rationale: Bethanechol chloride (Urecholine) stimulates muscarinic receptors, which can lead to bradycardia as an adverse effect. Monitoring for bradycardia is crucial when administering this medication. Constipation, hypertension, and dry mouth are not typically associated with the effects of bethanechol chloride.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Hearing loss. Gentamicin is an aminoglycoside antibiotic known for its potential ototoxicity, which can result in irreversible damage to the inner ear and lead to hearing loss. Therefore, any signs of hearing impairment while the client is receiving gentamicin should be immediately reported to the healthcare provider to prevent further harm. A) Nausea is a common side effect of gentamicin but is not typically considered a reason for immediate notification unless it is severe or persistent. C) Headache is not a typical side effect associated with gentamicin administration. While it should be monitored, it is not a priority over potential ototoxicity. D) Diarrhea is another common side effect of gentamicin, but it is not as urgent as hearing loss in terms of potential complications. It can be managed with appropriate interventions and monitoring. Educationally, this question emphasizes the importance of understanding the adverse effects of specific medications, particularly those with serious implications like gentamicin-induced ototoxicity. It highlights the need for vigilant monitoring and prompt reporting of concerning findings to ensure patient safety and prevent further complications.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Oliguria, which should prompt the healthcare professional to notify the healthcare provider immediately when monitoring a client receiving intravenous amphotericin B. Amphotericin B is a potent antifungal medication known for its nephrotoxic effects, which can lead to kidney damage. Oliguria, a decreased urine output, is a sign of potential kidney impairment or failure, which is a serious and potentially life-threatening adverse effect of amphotericin B. Option A) Fever is a common side effect of amphotericin B and is not typically an immediate cause for concern unless it is very high or accompanied by other severe symptoms. Option B) Headache is not a common or severe adverse effect of amphotericin B and would not typically require immediate notification of the healthcare provider. Option C) Nausea is a common side effect of amphotericin B but is not as concerning as oliguria, which indicates a more serious issue like kidney damage. Educationally, understanding the side effects and adverse reactions of medications is crucial for healthcare professionals to provide safe and effective care to their patients. Recognizing and responding promptly to signs of potential complications can prevent serious consequences and improve patient outcomes. In the case of amphotericin B, close monitoring for renal function and early detection of kidney-related issues such as oliguria are essential to ensure patient safety.

Correct Answer: C

Rationale: Furosemide (Lasix) is a diuretic that can lead to orthostatic hypotension, causing dizziness. Instructing the client to change positions slowly can help prevent this adverse effect. It is important for the client to consume foods rich in potassium to prevent hypokalemia. Taking furosemide in the morning helps reduce the need for frequent urination at night. Encouraging the client to maintain an adequate fluid intake is crucial to prevent dehydration while on this medication.