A nurse is caring for a client who has a respiratory infection and is receiving an antibiotic. Which of the following medications puts the client at risk for developing hearing loss?

Ototoxicity is a serious adverse effect of certain drug classes that results in damage to the cochlea or vestibular apparatus. Aminoglycosides are well-known for this risk, potentially causing permanent sensorineural hearing loss or equilibrium disturbances. Monitoring drug trough levels is a critical nursing intervention to minimize the accumulation of these drugs in the inner ear. Rationale: A. Rifampin is an antitubercular agent primarily known for hepatotoxicity and causing a harmless orange discoloration of body fluids. It is not associated with eighth cranial nerve damage or hearing loss. While it has many drug interactions, the nurse would prioritize monitoring liver function tests rather than auditory acuity for a client receiving this specific antibiotic medication. B. Gentamicin is an aminoglycoside antibiotic that is highly ototoxic and nephrotoxic. It can cause irreversible damage to the hair cells in the organ of Corti, leading to progressive hearing loss or tinnitus. The nurse must monitor the client for any changes in hearing or balance and ensure that serum peak and trough levels remain within the safe therapeutic range. C. Ciprofloxacin is a fluoroquinolone antibiotic that carries a boxed warning for tendon rupture and peripheral neuropathy, but it is not typically ototoxic. While it can cause central nervous system effects like dizziness, it does not target the auditory system. The nurse should focus on teaching the client about photosensitivity and avoiding minerals that interfere with the drug's absorption. D. Penicillin G is a beta-lactam antibiotic with a wide safety margin, primarily carrying risks for hypersensitivity and allergic reactions. It does not cause damage to the ears or hearing loss. If a client on Penicillin G experiences symptoms, the nurse should assess for signs of anaphylaxis or skin rashes rather than focusing on auditory or vestibular functioning.