A nurse is caring for a client who is receiving gentamicin. Which of the following findings should the nurse identify as a possible complication?

A. Dysuria, or painful urination, is not a common complication of gentamicin. While aminoglycosides are excreted by the kidneys, dysuria would typically indicate a urinary tract infection or irritation, not a direct side effect of the medication. Nursing assessment should focus more on renal function rather than urinary discomfort as a primary concern related to gentamicin. B. Gentamicin is an aminoglycoside antibiotic that carries a significant risk of ototoxicity. This complication can affect the cochlear branch (leading to hearing loss or tinnitus) or the vestibular branch (leading to vertigo, dizziness, or balance problems). Ototoxicity is often dose-dependent and more likely with prolonged therapy, high cumulative doses, or in clients with pre-existing renal impairment. Early recognition is crucial because ototoxicity can be irreversible. Nurses should assess for ringing in the ears, hearing loss, dizziness, or unsteady gait, and report any changes to the healthcare provider immediately. C. Constipation is not a known or typical adverse effect of gentamicin. Aminoglycosides generally have minimal gastrointestinal effects compared to other antibiotics such as macrolides or clindamycin. D. Diplopia, or double vision, is not a typical complication of gentamicin therapy. Rarely, aminoglycosides can cause neuromuscular blockade, which may present with generalized muscle weakness, but visual disturbances like diplopia are uncommon.