NCLEX-PN® ExaminationPharmacological TherapiesMedium
A client receiving IV vancomycin reports ringing in their ears and dizziness. The LPN notes the client's blood pressure is 98/60 mmHg and heart rate is 110 bpm. Which adverse effect is the client most likely experiencing?
- ANephrotoxicity
- BHypersensitivity reaction
- CRed Man Syndrome
- DOtotoxicity
Show answer & explanationAnswer & explanation
Correct answer: D. Ototoxicity
Ringing in the ears (tinnitus) and dizziness are classic symptoms of ototoxicity, a known adverse effect of vancomycin. While vancomycin can also cause nephrotoxicity and Red Man Syndrome, these symptoms are most indicative of ear damage.
Why the other options are wrong
- A. Nephrotoxicity would manifest as elevated BUN/creatinine and decreased urine output, not primarily tinnitus and dizziness.
- B. A general hypersensitivity reaction could include rash and bronchospasm, but the specific symptoms of tinnitus and dizziness point more directly to ototoxicity.
- C. Red Man Syndrome presents with flushing, rash, pruritus, and hypotension, typically occurring with rapid infusion, but tinnitus is not a primary symptom.
Vancomycin Ototoxicity
Damage to the eighth cranial nerve (auditory nerve) caused by vancomycin, leading to hearing loss, tinnitus, and vertigo.
- Symptoms: tinnitus, dizziness, hearing loss.
- Risk increased with high doses, prolonged therapy, renal impairment.
- Monitor drug levels and hearing.
Memory trick: Vancomycin's Vicious Cycle: Red Man, Renal Ruin, Ringing Ears!