Use sunscreen to prevent photosensitivity reactions.

• Assess for infection (vital signs, wound appearance, sputum, urine, stool, WBC) at beginning of and throughout therapy.

• Obtain specimens for culture and sensitivity before initiating therapy. First dose may be given before receiving results.

• Evaluate eighth cranial nerve function by audiometry before and throughout therapy. Hearing loss is usually in high-frequency range. Prompt recognition and intervention are essential in preventing permanent damage. Monitor for vestibular dysfunction (vertigo, ataxia, nausea, vomiting). Eighth cranial nerve dysfunction is associated with persistently elevated peak aminoglycoside levels. Aminoglycosides should be discontinued if tinnitus or subjective hearing loss occurs.

• Monitor intake and output and daily weight to assess hydration status and renal function.

• Assess for signs of superinfection (fever, upper respiratory infection, vaginal itching or discharge, increasing malaise, diarrhea).

Patient Teaching:

• Explain the purpose of gentamicin to patient.

• Instruct patient to report signs of hypersensitivity, tinnitus, vertigo, hearing loss, rash, dizziness, or difficulty urinating.

  • Advise patient of the importance of drinking plenty of liquids.

  • Teach patients with a history of rheumatic heart disease or valve replacement the importance of using antimicrobial prophylaxis before invasive medical or dental procedures.

• Rep:  May cause fetal harm. Advise females of reproductive potential use effective contraceptives during therapy and to notify health care professional if pregnancy is planned or suspected or if breastfeeding. Monitor breastfed infants for thrush and diarrhea.

• Topical Instruct patient to wash affected skin gently and pat dry. Apply a thin film of ointment. Apply occlusive dressing only if ordered by health care professional. Patient should assess skin and inform health care professional if skin irritation develops or infection worsens.

Visitors should not use same bathroom or utensils as patient.

Encourage patient to complete antibiotic treatment even if symptoms improve and implement a pro-biotic to support extra good bacteria in the gut.

Obtain specimens for culture and sensitivity before initiating therapy. First dose may be given before receiving results.

Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of Clostridioides difficile-associated diarrhea (CDAD). May begin up to several wk following cessation of therapy

Patient teaching:

Hydration

Position: semi-fowlers position to help breathing and expand lungs

Incentive spirometer

Hand washing

cover mouth and nose while cough

INTERACTIONS : May ↓ the therapeutic effect of  influenza virus vaccine ; avoid use 2 days prior to and 2 wk after vaccine administration.

NURSING IMPLECATIONS : PO May be administered with food or milk to minimize GI irritation.

Lab test: Monitor hepatic function before and every 2-4 weeks during therapy

Monitor serum uric acid

Nursing Implications

• Monitor for decreased frequency of urination

• Darkening urine color

• peripheral edema

• Thirst/Dry skin

Patient Teaching

• Do NOT take more or less than what is prescribed to you

Side Effects

• low potassium

• nausea

• stomach pain

Across the lifespan

• pregnancy- Only should be used if only clearly necessary

• Infant/Children- Just the normal small dose by weight

• Geriatric- no contradictions with the medication, some side effects may be more shown in elderly