Gastrointestinal Disorders - ML5

Which nursing intervention is the best way to help reduce the occurrence of poisoning in children? Identify children who are at risk of poisoning. Place the number for poison control in the home. Provide education to those who care for children. Teach parents to read toy labels.

Provide education to those who care for children. Explanation: Educating those who care for children about poisoning is the best way to reduce the occurrence of poisoning. Identifying high-risk groups will help but won't reduce poisoning. Reading toy labels will help to identify toys that may contain lead and may help reduce lead exposure. Having the number to poison control is essential if poisoning has occurred but will not prevent poisoning.

A nurse is caring for a client with chronic pancreatitis. Which response by the client indicates that discharge education has been effective? "I can have an occasional glass of wine." "I'll take pancreatic enzymes before breakfast and at bedtime." "I'll take pancreatic enzymes with each meal." "I'll eat a low-carbohydrate diet."

"I'll take pancreatic enzymes with each meal." Explanation: Oral pancreatic enzymes are taken with each meal to aid digestion and control steatorrhea. The client should adhere to a low-fat (not low-carbohydrate) diet. The client should eliminate alcohol from his diet completely as it will continue to cause pancreatic damage.

A client with colon cancer asks the nurse why radiation therapy is being received before surgery. Which response would be most appropriate? "It helps reduce the size of the tumor." "It eliminates the malignant cells." "The chances of curing the cancer are improved." "The therapy helps to heal the bowel after surgery."

"It helps reduce the size of the tumor." Explanation: Radiation therapy is used to treat colon cancer before surgery to reduce the size of the tumor, making it easier to resect. Radiation therapy can't eliminate the malignant cells (though it helps to define tumor margins), isn't curative, and could slow postoperative healing.

The nurse is providing dietary instructions to a client with a history of pancreatitis. Which instruction is correct? "Maintain a high-sodium, high-calorie diet." "Maintain a high-fat, high-carbohydrate diet." "Maintain a high-carbohydrate, low-fat diet." "Maintain a high-fat diet and drink at least 3 L of fluid a day."

"Maintain a high-carbohydrate, low-fat diet." Explanation: A client with a history of pancreatitis should avoid foods and beverages that stimulate the pancreas, such as fatty foods, caffeine, and gas-forming foods; should avoid eating large meals; and should eat plenty of carbohydrates, which are easily metabolized. An increased sodium or fluid intake isn't necessary because chronic pancreatitis isn't associated with hyponatremia or fluid loss.

The nurse has reinforced education for a teenage client and the parents about Crohn's disease and the dietary changes needed to manage it. Which statement made to the nurse by the parents indicates an accurate understanding of the child's dietary needs? "We'll only give our child foods that are low in sodium." "We'll be sure to provide foods that are high in fiber for our child." "We'll need to include plenty of calories in our child's diet." "We'll need to make certain that our child's food is gluten-free."

"We'll need to include plenty of calories in our child's diet." Explanation: Crohn's disease is an inflammatory bowel disease that causes diarrhea with subsequent weight loss and malnutrition. A high-calorie, nutritious diet helps replenish nutrients that are lost through the affected bowel. A gluten-free diet is appropriate for a client with celiac disease, not Crohn's disease. A client with Crohn's disease doesn't need to restrict dietary sodium but should avoid high-fiber foods during a flareup of the disease because these foods can contribute to bowel irritation.

A client who has just been diagnosed with hepatitis A asks, "How could I have gotten this disease?" What is the nurse's best response? "You may have eaten contaminated restaurant food." "You probably got it by engaging in unprotected sex." "You could have gotten it by using I.V. drugs." "You must have received an infected blood transfusion."

"You may have eaten contaminated restaurant food." Explanation: Hepatitis A virus typically is transmitted by the oral-fecal route — commonly by consuming food contaminated by infected food handlers. The virus isn't transmitted by the I.V. route, blood transfusions, or unprotected sex. Hepatitis B can be transmitted by I.V. drug use or blood transfusion. Hepatitis C can be transmitted by unprotected sex.

A client with pancreatitis has been receiving total parenteral nutrition (TPN) for the past week. Which nursing intervention would the nurse use to determine if TPN is providing adequate nutrition? Ensuring that the TPN tubing has an in-line filter Recording fluid intake and output Monitoring the client's weight every day Accelerating the infusion if it falls behind schedule

Monitoring the client's weight every day Explanation: By weighing the client every day, the nurse helps the team evaluate the client's response to TPN. Maintenance of the current weight is one indicator of adequate nutrition; weight loss may indicate inadequate nutrition, whereas weight gain may indicate adequate nutrition or fluid retention. The nurse shouldn't accelerate a TPN infusion that has fallen behind because this can cause wide fluctuations in the blood glucose level. Use of an in-line filter on TPN tubing traps bacteria and particles but has no effect on nutrition. The nurse records intake and output to evaluate fluid replacement — not the nutritional adequacy of TPN.

A client with abdominal pain secondary to a malignant mass in the colon is receiving fentanyl by transdermal patch. His current patch expires in 48 hours and he reports a pain level of 8 on a 1-to-10 scale. What should a nurse do? Massage the patch. Notify the client's physician. Replace the patch with a new patch. Apply a warm compress to the patch.

Notify the client's physician. Explanation: Because the client is not receiving adequate pain relief from the fentanyl patch, the client's physician should be notified. It is inappropriate to replace the patch early. Massaging the patch or applying warmth to it may increase the drug's absorption, but these are not acceptable practices because the patch is designed to release the drug at a controlled rate over a 3-day period.

The nurse receives a shift report on a client who is 2 days postoperative bowel resection and reports the sudden onset of pain unrelieved by pain medication. The abdomen is rigid and bowel sounds are absent. Which action should the nurse take next? Obtain a complete set of vital signs. Administer a dose of pain medication. Notify the health care provider. Perform an abdominal assessment.

Obtain a complete set of vital signs. Explanation: The client is exhibiting signs of peritonitis. The nurse needs a set of vital signs to make sure that the client is not going into shock from hidden bleeding before calling the provider. The abdominal assessment has been completed—there are not bowel sounds. Once the vital signs are gathered, the health care provider should be notified.

A nurse is caring for a client with an ileostomy. What is the most common complication of this procedure? Stoma stenosis Cholelithiasis Peristomal skin irritation Urinary calculi

Peristomal skin irritation Explanation: Although all of these options can be complications of an ileostomy, peristomal skin irritation from leakage of effluent is the most common complication. An ill- fitting pouch is often the cause. Stoma stenosis is caused by scar tissue formation at the stoma site. Urinary calculi may occur because of dehydration secondary to decreased fluid intake. Cholelithiasis may occur because of changes in the absorption of bile acids postoperatively.

A client presents to the outpatient center for a gastroscopy that reveals redness and inflammation of the stomach indicating acute gastritis. Which action should be included in the immediate management? Advise the client to reduce work-related stress. Treat the underlying cause of disease. Prepare the client for gastric resection. Administer enteral tube feedings.

Treat the underlying cause of disease. Explanation: Discovering and treating the cause of gastritis is the most beneficial approach in the immediate management phase. Reducing the amount of stress and reducing or eliminating oral intake until the symptoms are gone are important in the recovery phase. A gastric resection is considered only when serious erosion has occurred.

A client with viral hepatitis A is being treated in an acute care facility. To prevent spread of the disease, the nurse uses which precaution? Wear a mask when handling the client's bedpan. Wear gloves when caring for the client and wash her hands after touching the client. Place the client in a private room. Wear a gown when providing personal care for the client.

Wear gloves when caring for the client and wash her hands after touching the client. Explanation: To maintain enteric precautions and prevent spread of the disease, the nurse must wear gloves when caring for the client and when contamination with stool is likely. The nurse must also wash her hands after touching the client or potentially contaminated articles and before caring for another client. A private room is warranted only if the client has poor hygiene — for instance, if the client is unlikely to wash the hands after touching infective material or is likely to share contaminated articles with other clients. For enteric precautions, the nurse need not wear a mask and must wear a gown only if soiling from fecal matter is likely.

After laparoscopic cholecystectomy, a client reports abdominal pain. The nurse prepares morphine 2 mg. If the label on the morphine reads 10 mg/ml, how many milliliters should the nurse have in the syringe after the correct dose is drawn up? Record your answer using one decimal place.

0.2 Explanation: This formula is used to calculate drug dosages:Dose on hand ÷ Quantity on hand = Dose desired ÷ XIn this example, the formula for calculating the amount of morphine is as follows:10 mg/ml = 2 mg/XX = 0.2 ml

When collecting data on a client during a routine checkup, the nursing student reviews the history and notes that the client had aphthous stomatitis at the time of the last visit. The student asks the nurse what is aphthous stomatitis? What is the nurse's best response? "Aphthous stomatitis is a canker sore of the oral soft tissues." "Aphthous stomatitis is acid indigestion." "Aphthous stomatitis is an acute stomach infection." "Aphthous stomatitis is an early sign of peptic ulcer disease."

"Aphthous stomatitis is a canker sore of the oral soft tissues." Explanation: Aphthous stomatitis refers to a canker sore of the oral soft tissues, including the lips, tongue, and inside of the cheeks. Aphthous stomatitis isn't an acute stomach infection, acid indigestion, or early sign of peptic ulcer disease.

A client with a peptic ulcer is about to begin a therapeutic regimen that includes a bland diet, antacids, and ranitidine. Before the client is discharged, the nurse should provide which instruction? "Increase your intake of fluids containing caffeine." "Stop taking the drugs when your symptoms subside." "Eat three balanced meals every day." "Avoid aspirin and products that contain aspirin."

"Avoid aspirin and products that contain aspirin." Explanation: Aspirin is a gastric irritant and should be avoided by clients with peptic ulcer to prevent further erosion of the stomach lining. The client should eat small, frequent meals rather than three large ones. Antacids and ranitidine prevent acid accumulation in the stomach; they should be taken even after symptoms subside. Caffeine should be avoided because it increases acid production in the stomach.

A client is diagnosed with a hiatal hernia. Which statement indicates effective client teaching about hiatal hernia and its treatment? "I'll gradually increase the amount of heavy lifting I do." "I'll eat frequent, small, bland meals that are high in fiber." "I'll eat three large meals every day without any food restrictions." "I'll lie down immediately after a meal."

"I'll eat frequent, small, bland meals that are high in fiber." Explanation: In hiatal hernia, the upper portion of the stomach protrudes into the chest when intra-abdominal pressure increases. To minimize intra-abdominal pressure and decrease gastric reflux, the client should eat frequent, small, bland meals that can pass easily through the esophagus. Meals should be high in fiber to prevent constipation and minimize straining on defecation (which may increase intra-abdominal pressure from the Valsalva maneuver). Eating three large meals daily would increase intra-abdominal pressure, possibly worsening the hiatal hernia. The client should avoid spicy foods, alcohol, and tobacco because they increase gastric acidity and promote gastric reflux. To minimize intra-abdominal pressure, the client shouldn't recline after meals, lift heavy objects, or bend.

A client with recent onset of epigastric discomfort is scheduled for an upper GI series (barium swallow). When teaching the client how to prepare for the test, which instruction should the nurse provide? "Take a potent laxative the day before the test." "Eat a low-residue diet for 2 days before the test." "Avoid eating or drinking anything for 6 to 12 hours before the test." "Eat a clear liquid diet for 2 days before the test."

"Avoid eating or drinking anything for 6 to 12 hours before the test." Explanation: The client must refrain from eating or drinking for 6 to 12 hours before an upper GI series. No other preparation is needed. Before a lower GI series, the client should eat a low-residue or clear liquid diet for 2 days and take a potent laxative (along with an oral liquid preparation).

The nurse is reinforcing discharge instructions to a client with chronic cholecystitis. Which response by the client indicates the education has been effective? "I should increase the fat in my diet." "I should avoid taking antacids." "I need to rest more." "I will take my anticholinergic medications as prescribed."

"I will take my anticholinergic medications as prescribed." Explanation: Conservative therapy for chronic cholecystitis includes weight reduction by increasing physical activity, a low-fat diet, antacid use to treat dyspepsia, and anticholinergic use to relax smooth muscles and reduce ductal tone and spasm, thereby reducing pain.

A client was hospitalized and treated for acute diverticulitis. The nurse has reinforced discharge education. Which statement by the client indicates that the client understands the discharge instructions? "I'll decrease the fiber in my diet." "I'll exercise to increase my intra-abdominal pressure." "I'll reduce my fluid intake." "I'll take all of my antibiotics."

"I'll take all of my antibiotics." Explanation: Antibiotics are used to reduce inflammation. The client with acute diverticulitis typically isn't allowed anything orally until the acute episode subsides. Parenteral fluids are given until the client feels better; then it's recommended that the client drink eight 8-oz (237-ml) glasses of water per day and gradually increase fiber in the diet to improve intestinal motility. During the acute phase, activities that increase intra-abdominal pressure should be avoided to decrease pain and the chance of intestinal obstruction.

The nurse admits a client with Crohn's disease who is experiencing an exacerbation. Which intervention should the nurse make a priority of care? maintaining current weight promoting bowel rest encouraging ambulation providing mouth care

promoting bowel rest Explanation: Promoting bowel rest is the priority during an acute exacerbation. This is accomplished by decreasing activity and initially putting the client on nothing-by-mouth (NPO) status. Weight loss may occur, but the priority is bowel rest.

A client diagnosed with glossitis is prescribed a diet high in folic acid. When assisting with the development of a teaching plan for this client, which food products will the nurse reinforce to fulfill the need for increased folic acid? yogurt strawberries poultry spinach

spinach Explanation: Green, leafy vegetables, such as spinach, are high in folic acid. Poultry is high in vitamin B. Strawberries are high in vitamin C. Yogurt is high in vitamin B.

The nurse is reinforcing discharge instructions to a client with chronic cholecystitis. Which response by the client indicates the education has been effective?

2 Explanation: First, convert from g to mg. 1 g to mg: 1,000 mg = 1 g, therefore the order is for 1000 mg of neomycin. Then use this formula for calculating the number of tablets to administer: Desired/Form on hand = Dose 1000 g/500 mg = 2 tablets

At the beginning of the shift, the nurse is assigned a client with an ascending colostomy. Which picture identifies the correct placement where the nurse will assess the stoma?

A colostomy can be performed along any site of the colon. The location of an ascending colostomy is on the right side of the abdomen. An ostomy located in the ascending colon would likely produce continuous liquid output because feces in this section contain the most water and, therefore, have a liquid consistency. A sigmoid colostomy is located on the sigmoid colon and located close to the location of a descending colostomy in the left side of the abdomen. The transverse colostomy is horizontal across middle abdomen or toward the right side of the body across the abdomen.

After checking the client's chart for possible contraindications, the nurse is administering meperidine, 50 mg I.M., to a client with pain after an appendectomy. The nurse would question which medication if noted on the physician's orders for this client? A loop diuretic An antiemetic An antibiotic A monoamine oxidase (MAO) inhibitor

A monoamine oxidase (MAO) inhibitor Explanation: MAO inhibitors increase the effects of meperidine and can cause rigidity, hypotension, and excitation. The client shouldn't receive meperidine within 14 days after administration of an MAO inhibitor. Antibiotics, antiemetics, and loop diuretics don't cause significant drug interactions when administered concurrently with meperidine.

The physician orders morphine for a client who complains of postoperative abdominal pain. The nurse is monitoring the client and will anticipate administering morphine at what time? Every 3 hours, whether or not the client has pain When the pain becomes severe Before the pain becomes severe As seldom as possible to avoid morphine dependency

Before the pain becomes severe Explanation: For greatest analgesic effectiveness, the nurse should administer an opioid agonist, such as morphine, before the client's pain becomes severe. If the nurse waits until the pain becomes severe, the medication will be less effective, taking longer to provide relief. Giving morphine every 3 hours whether or not the client has pain would be inappropriate because the client may need a larger dose if the pain worsens. Giving morphine as seldom as possible to avoid dependency would cause needless client suffering.

A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse instructs the nursing student to observe this client's stools for which finding? Coffee-ground-like Black and tarry Bright red Clay-colored

Black and tarry Explanation: Black, tarry stools are a sign of bleeding high in the GI tract, as from a gastric ulcer, and result from the action of digestive enzymes on the blood. Vomitus associated with upper GI tract bleeding commonly is described as coffee-ground-like. Clay-colored stools are associated with biliary obstruction. Bright red stools indicate lower GI tract bleeding.

A client with a new colostomy asks the nurse how to avoid detachment from the ostomy bag. What is the best response by the nurse? Limit fluid intake. Eat more fruits and vegetables. Empty the bag when it's about half full. Tape the end of the bag to the surrounding skin.

Empty the bag when it's about half full. Explanation: Emptying the bag when partially full prevents the bag from becoming heavy and detaching from the skin or skin barrier. Limiting fluids may cause constipation, but won't prevent leakage. Increasing fruits and vegetables in the diet will help prevent constipation, not leakage. Taping the bag to the skin will secure the bag to the skin, but won't prevent detachment and could irritate the surrounding skin.

The nurse is caring for a client who is postoperative after abdominal surgery and reporting "gas pains." What action by the nurse can assist the client with alleviating the discomfort associated with gas? Have the client turn to the right side. Administer opioid analgesics. Encourage the client to ambulate. Encourage the client to drink iced liquids.

Encourage the client to ambulate. Explanation: The nurse should encourage the client to ambulate to increase peristaltic movement of the bowel to alleviate gas and promote bowel function. Opioid analgesics often make the problem of gas worse by slowing motility. Hot liquids and not cold promote the elimination of gas. The client should lay on the left side to promote evacuation of gas.

One day after undergoing a traditional cholecystectomy, a client is scheduled to stand at the bedside and walk. What should a nurse teach the client to do before standing and walking for the first time after surgery? Place the bed in the flat position before getting out of bed. Maintain a slightly flexed-at-the-waist position when walking. Flex her legs when moving to a sitting position. Relax her buttock muscles when rising to a standing position.

Flex her legs when moving to a sitting position. Explanation: Flexing the legs when moving to a sitting position reduces the tension on the abdomen and the pain associated with moving. The bed should be placed in the sitting position, rather than flat. The client should be encouraged to stand erect when walking, not flexed at the waist. The buttock muscles should be tightened so that the act of moving uses the leg and buttock muscles rather than the abdominal muscles.

A nurse is discussing inflammatory bowel disease (IBD) with second-term nursing students. Which factors about IBD will the nurse include in her presentation? Diarrhea is the most common sign of IBD. Bowel cancer is common in clients with a history of Crohn's disease, one form of IBD. Transmural inflammation with fistula formation occurs in ulcerative colitis, one form of IBD. Abscesses may occur in IBD because poor nutrition causes breakdown of cells in the GI tract. IBD is a collective term for several GI inflammatory diseases with unknown causes.

IBD is a collective term for several GI inflammatory diseases with unknown causes. Diarrhea is the most common sign of IBD. Explanation: IBD is a collective term for several GI inflammatory diseases with unknown causes. The most prominent sign of IBD is mild diarrhea, which sometimes is accompanied by fever and abdominal discomfort. The pathophysiology of ulcerative colitis involves vascular congestion, hemorrhage, and edema—usually affecting the rectum and left colon. Although abscesses may occur in IBD, they result from buildup of lymphocytes and cellular debris in crypts, which may serve as abscess sites. Only about 3% of clients with a long history of Crohn's disease develop bowel cancer.

A client with pancreatitis has been receiving total parenteral nutrition (TPN) for the past week. Which nursing intervention would the nurse use to determine if TPN is providing adequate nutrition? Ensuring that the TPN tubing has an in-line filter Accelerating the infusion if it falls behind schedule Recording fluid intake and output Monitoring the client's weight every day

Monitoring the client's weight every day Explanation: By weighing the client every day, the nurse helps the team evaluate the client's response to TPN. Maintenance of the current weight is one indicator of adequate nutrition; weight loss may indicate inadequate nutrition, whereas weight gain may indicate adequate nutrition or fluid retention. The nurse shouldn't accelerate a TPN infusion that has fallen behind because this can cause wide fluctuations in the blood glucose level. Use of an in-line filter on TPN tubing traps bacteria and particles but has no effect on nutrition. The nurse records intake and output to evaluate fluid replacement — not the nutritional adequacy of TPN.

A client is scheduled for an endoscopy. On admission, the nurse asks the client if he has an advance directive, and the client states, "No." What should the nurse do next? Refer the client to the admissions office, where he can obtain an advance directive. Advise the client that an advance directive is required before the procedure. Ask the client if he has a substitute document, such as a living will or a durable power of attorney. Provide the client with information about an advance directive.

Provide the client with information about an advance directive. Explanation: As a client advocate, a nurse must ensure that a client has adequate information on the advance directive so that he can make an informed decision about this legal document. A client isn't required to sign an advance directive before a procedure. Living wills and durable powers of attorney are forms of advance directives, not substitutes. The nurse should be able to inform the client about the advance directive and not have to refer the client to the admissions office for the information.

A nurse is assigned to care for a client with peptic ulcer disease. Which finding will the nurse report immediately to the health care provider? abdominal pain loss of appetite heart rate 126 bpm blood pressure 140/84 mm Hg

Pulse rate is a cardiovascular system assessment, and tachycardia is an indicator of hidden bleeding, as well as a compensatory mechanism when a client is in the early stage of shock. Loss of appetite can occur from a number of factors and is not something to be alarmed about. Abdominal pain is expected with peptic ulcer disease. BP of 140/84 mm Hg is not an indicator of GI bleeding.

A physician asks a nurse to witness an informed consent of a client scheduled for gastric bypass surgery. What should the nurse do? Explain the procedure to the client before signing the consent. Sign the consent only if she sees the client sign it. Sign the consent if the physician says that the client has already signed it in front of him. Tell the physician that only registered nurses can witness consents.

Sign the consent only if she sees the client sign it. Explanation: Witnessing consent requires that the witness actually see the client sign the consent. A practical nurse as well as a registered nurse may witness consent. It is the physician's responsibility to explain the procedure to the client, not the nurse's.

The client with a peptic ulcer is prescribed an antacid. After administering the medication, the nurse assesses the pH of which organ contents to determine effectiveness? Stomach Large intestine Esophagus Small intestine

Stomach Explanation: The action of an antacid occurs in the stomach. The anions of an antacid combine with the acidic hydrogen cations secreted by the stomach to form water, thereby increasing the pH of the stomach contents. Increasing the pH and decreasing the pepsin activity provide symptomatic relief from peptic ulcer disease. Antacids don't work in the large or small intestine or in the esophagus.

Which outcome indicates effective client teaching to prevent constipation? The client limits water intake to three glasses per day. The client maintains a sedentary lifestyle. The client verbalizes consumption of low-fiber foods. The client reports engaging in a regular exercise regimen.

The client reports engaging in a regular exercise regimen. Explanation: A regular exercise regimen promotes peristalsis and contributes to regular bowel elimination patterns. A low-fiber diet, a sedentary lifestyle, and limited water intake would predispose the client to constipation.

A client is undergoing an extensive diagnostic workup for a suspected GI problem. The nurse discovers that the client has a family history of ulcer disease. When reviewing the client's laboratory results, the nurse expects to find which blood type (a risk factor for duodenal ulcers)? Type B Type AB Type O Type A

Type O Explanation: Duodenal ulcers are more common in people with type O blood, suggesting a genetic basis. Types A, B, and AB blood aren't associated with an increased incidence of duodenal ulcers. People with type A blood have a higher incidence of gastric ulcers.

A client reports right lower quadrant pain, nausea, vomiting, and a low-grade fever for the past 12 hours. The health care provider documents rebound tenderness, an elevated white blood cell count (WBC), and positive psoas sign. Based on these findings, what would the nurse suspect? cholecystitis pancreatitis constipation appendicitis

appendicitis Explanation: Right lower quadrant pain, rebound tenderness, nausea, vomiting, elevated WBC, a positive psoas sign, and a low-grade fever are findings consistent with acute appendicitis. The other disorders may mimic appendicitis; however, the pain of pancreatitis is usually localized in the left upper quadrant, cholecystitis is associated with right upper quadrant pain, and constipation would not cause a fever.

The nurse is caring for a client with an endotracheal tube who receives enteral feedings through a feeding tube. Before each tube feeding, the nurse checks for tube placement in the stomach as well as residual volume. The purpose of the nurse's actions is to avoid: diarrhea. abdominal distention. aspiration. gastric ulcers.

aspiration. Explanation: Protecting the client from aspiration is essential because aspiration can cause pneumonia, a potentially life-threatening disorder. Gastric ulcers aren't a common complication of tube feeding in clients with endotracheal or tracheostomy tubes. Abdominal distention and diarrhea can both be associated with tube feeding but neither is immediately life-threatening.

A nurse is caring for a client with a retroperitoneal abscess who is receiving gentamicin 300 mg IV every 8 hours. Which client data should the nurse monitor? Select all that apply. hearing hematocrit urine output BUN and serum creatinine levels muscle tone serum calcium level

hearing urine output BUN and serum creatinine levels Explanation: Adverse effects of gentamicin include ototoxicity and nephrotoxicity; consequently, the nurse must monitor the client's hearing and instruct the client to report any hearing loss or tinnitus. Signs of nephrotoxicity include decreased urine output and elevated BUN and serum creatinine levels. Gentamicin does not affect the serum calcium level, HCT, or muscle tone.