Respiratory Question #14


The nurse is caring for a client with bacterial pneumonia who is receiving gentamycin. Which laboratory value is most important to monitor by the nurse?


  1. Serum potassium.
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  2. Serum sodium.
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  3. Serum creatinine.
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  4. Serum alkaline phosphatase (ALP).
    • Rationale:



Serum creatinine must be monitored while on an aminoglycoside like gentamycin because the medication may cause tubular necrosis, and the kidneys via glomerular filtration primarily excrete the drugs. Electrolyte monitoring (such as potassium and sodium) is not used to monitor aminoglycosides. Hepatic injury with use of gentamycin is not as common as kidney disease since the drug is mainly excreted in the urine; however, having hepatic disease may increase the risk of kidney function. The drug is found in renal tubular cells and hair cells of inner ear which may also cause hearing loss.

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