Question

A nurse is collecting data from a client who is taking tobramycin. Which of the following findings should the nurse report to the provider immediately?

a) Increased blood pressure
b) Decreased urinary output
c) Elevated temperature
d) Improved appetite

Answer 1

Decreased urinary output is a critical finding that a nurse should report immediately when a patient is on tobramycin, as it can indicate nephrotoxicity and possible acute kidney injury.

Step-by-step explanation:

A nurse is collecting data from a client who is taking tobramycin, an antibiotic medication. Among the findings listed, the nurse should report decreased urinary output to the provider immediately. Decreased urinary output could signify nephrotoxicity, which is a serious potential side effect of tobramycin. This complication can lead to acute kidney injury. It is important to monitor renal function closely in patients taking this medication, and a sudden decrease in urinary output is an indication that the kidneys may be adversely affected.

Moreover, the physiological responses to decreased blood pressure include the release of renin from the kidneys (not the liver, as in the provided reference), which in turn stimulates the aldosterone system. Aldosterone works to conserve sodium and water, hence reducing urine output to increase blood volume. However, if a medication leads to increased urine output, as seen with diuretics, it can cause electrolyte disturbances and hypotension, potentially complicating the clinical picture.