RN Nursing · Vancomycin and Clindamycin · Practice question
A nurse is reinforcing teaching about vancomycin with a client who has an infection. Which of the following information should the nurse include in the teaching?
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“Notify your provider if you experience any changes in your hearing."
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"Discontinue the medication once your symptoms subside."
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“Expect your urine to turn pink or red while taking this medication."
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"Decrease your fluid intake to 1000mL per day.”
Answer & explanation
Correct: “Notify your provider if you experience any changes in your hearing."
Vancomycin is a glycopeptide antibiotic with two well-known serious adverse effects: ototoxicity and nephrotoxicity. Clients receiving vancomycin should be taught to report any changes in hearing, including ringing in the ears (tinnitus), muffled hearing, or hearing loss, because these symptoms may signal ototoxicity, which can be irreversible if the drug is not discontinued promptly. This makes notifying the provider about hearing changes the most important teaching point. Instructing a client to discontinue the medication once symptoms subside is incorrect and dangerous because completing the full course is essential to eradicate the infection and prevent antibiotic resistance. Vancomycin does not cause the urine to turn pink or red; that characteristic is associated with rifampin. Decreasing fluid intake to 1,000 mL per day is contraindicated because adequate hydration is necessary to reduce the risk of nephrotoxicity; clients are actually encouraged to maintain good hydration. Monitoring serum drug levels (peak and trough) is also routinely performed to prevent toxicity, further emphasizing the importance of vigilance regarding hearing and kidney function throughout the course of therapy.
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