A nurse is caring for a client receiving an intermittent IV bolus of gentamicin twice daily. Which of the following laboratory values should the nurse monitor while the client is receiving this medication? (Select all that apply).

Choice A rationale Glucose monitoring is primarily indicated for clients with diabetes mellitus or those receiving medications known to affect blood sugar, such as corticosteroids. Gentamicin, an aminoglycoside antibiotic, does not significantly impact blood glucose metabolism or homeostatic regulation, so it is not a standard monitoring parameter. Normal fasting blood glucose is 70 to 100 mg/dL. Choice B rationale Prothrombin time (PT) measures the time it takes for blood plasma to clot and is a key indicator of the extrinsic and common coagulation pathways. It is monitored when a client is on anticoagulant therapy like warfarin, but not when receiving gentamicin, which has no direct effect on the coagulation cascade. Normal PT is typically 11 to 13.5 seconds. Choice C rationale Gentamicin is a known nephrotoxic medication. It accumulates in renal tubular cells, leading to cellular damage and acute kidney injury. Monitoring serum creatinine, a marker of renal function, is crucial to detect early signs of kidney damage. The normal range for serum creatinine is approximately 0.6 to 1.2 mg/dL. Choice D rationale Cardiac enzymes such as troponin and creatine kinase (CK-MB) are biomarkers used to diagnose myocardial injury or infarction. Gentamicin does not have cardiotoxic effects and does not alter cardiac enzyme levels. Therefore, monitoring these enzymes is not a standard part of gentamicin therapy. Choice E rationale Gentamicin is an antibiotic used to treat severe bacterial infections. A white blood cell (WBC) count is a primary indicator of infection severity and the body's response to the pathogen. Monitoring the WBC count helps to assess the efficacy of the antibiotic therapy. A normal WBC count is typically 4,500 to 11,000 cells/mm³.