Question

On reviewing the medication history of a patient, the nurse finds that the patient is on long-term gentamicin (Garamycin) therapy. Which risk does the nurse expect the patient to have?

Acute otitis media

Conductive hearing loss

Sensorineural hearing loss

Chondrodermatitis nodularis helicis

Answer 1

The nurse should expect the patient on long-term gentamicin therapy to have an increased risk of sensorineural hearing loss due to the ototoxic nature of aminoglycosides like gentamicin. Ototoxicity can cause permanent and irreversible damage to the inner ear or auditory nerve, leading to hearing loss.

Step-by-step explanation:

On reviewing the medication history of a patient who is on long-term gentamicin therapy, the nurse should be aware of the potential risk of sensorineural hearing loss. Gentamicin belongs to a class of antibiotics known as aminoglycosides, which are known for their broad-spectrum antibacterial properties. These drugs, including gentamicin, streptomycin, and tobramycin, bind to the 30S subunit of bacterial ribosomes, impairing protein synthesis and resulting in bacterial cell death.

However, aminoglycosides, while potent, have significant side effects. They are known to be nephrotoxic (damaging to kidneys), neurotoxic (damaging to the nervous system), and specifically ototoxic (damaging to the ear). Ototoxicity can lead to sensorineural hearing loss, which is the loss of hearing due to damage to the inner ear or the nerve pathways from the inner ear to the brain. Unlike conductive hearing loss, which involves the outer or middle ear and is often treatable, sensorineural hearing loss is generally permanent and irreversible.

Long-term use of gentamicin increases the risk of developing ototoxicity. The damage occurs when the medication affects the hair cells in the cochlea of the inner ear, which are essential for translating sound waves into nerve signals. This form of hearing loss does not always have immediate symptoms and may be gradual, necessitating regular audiological assessments during therapy with gentamicin.

In conclusion, nurses should monitor patients on long-term gentamicin therapy for symptoms of hearing loss, and these patients should undergo periodic hearing evaluations to detect any potential damage early on. The risk of ototoxicity underscores the importance of using gentamicin cautiously and only when necessary, as its potential to cause permanent hearing loss is a serious concern.