Final answer:
A nurse should report tinnitus and hearing loss immediately when a client is taking tobramycin, as these are signs of ototoxicity, a serious side effect of the medication.
Step-by-step explanation:
When monitoring a client who is taking tobramycin, which is an aminoglycoside antibiotic, the nurse should report tinnitus and hearing loss immediately to the healthcare provider. These symptoms are indicative of ototoxicity, a serious and potentially irreversible side effect of aminoglycosides. Ototoxicity can lead to permanent hearing loss, which is why prompt intervention is necessary to potentially halt or reverse the progression of this side effect.
Tobramycin can also cause nephrotoxicity, which is another serious side effect to monitor for, although it is not listed as an option in the question. While other symptoms such as nausea and vomiting, increased blood pressure, and mild headache and dizziness can be concerning and should be addressed, they do not usually require immediate reporting in the same way that signs of ototoxicity do.