Question

The nurse is administering medication to four clients. Which client should be most closely monitored for signs of ototoxicity? A. A 20-year-old receiving ciprofloxacin (Cipro) for a urinary tract infection B. A 75-year-old receiving amikacin sulfate (Amikin) for pneumonia C. A 46-year-old receiving cefazolin sodium (Ancef) for sinusitis D. A 6-month-old receiving amoxicillin/clavulanate potassium (Augmentin) for otitis media

Short answer

Answer: Client B, a 75-year-old receiving amikacin sulfate (Amikin) for pneumonia, should be most closely monitored for signs of ototoxicity.

Step-by-step solution

Understanding Medications and Ototoxicity

The first thing to do in this exercise is to understand which medications are known to cause ototoxicity. Based on the available options, the medications are: 1. Ciprofloxacin (Cipro) 2. Amikacin sulfate (Amikin) 3. Cefazolin sodium (Ancef) 4. Amoxicillin/clavulanate potassium (Augmentin) A basic understanding of pharmacology shows that amikacin sulfate (Amikin) is an aminoglycoside antibiotic, and aminoglycosides are well-known for their potential to cause ototoxicity.

Evaluating Client Age and Condition

Now that we understand which medication is known for its ototoxic effects, let's consider the client's age and medical conditions: A. 20-year-old receiving ciprofloxacin (Cipro) for a urinary tract infection B. 75-year-old receiving amikacin sulfate (Amikin) for pneumonia C. 46-year-old receiving cefazolin sodium (Ancef) for sinusitis D. 6-month-old receiving amoxicillin/clavulanate potassium (Augmentin) for otitis media Obviously, client B is receiving Amikin, which is known to cause ototoxicity. Furthermore, elderly clients (in this case, the 75-year-old) are more susceptible to the side effects of medications, as their bodies are generally less efficient at metabolizing and eliminating drugs.

Identifying the Client at Highest Risk

Based on the information provided, client B, a 75-year-old receiving amikacin sulfate (Amikin) for pneumonia, is the most likely candidate to be closely monitored for ototoxicity. This is due to the combination of the drug's known ototoxic potential and the client's advanced age, which makes them more susceptible to the side effects of medications.