A nurse is caring for a client who is receiving tobramycin. The nurse should monitor the client for which of the following adverse effects?

Choice A rationale Tobramycin is an aminoglycoside antibiotic known for its potential to cause ototoxicity, which manifests as damage to the auditory or vestibular systems. Tinnitus, a ringing or buzzing in the ears, is a common early sign of auditory toxicity and indicates damage to the cochlea, requiring immediate attention to prevent irreversible hearing loss. Choice B rationale Joint pain is not a commonly reported or significant adverse effect of tobramycin. While some musculoskeletal complaints can occur with various medications, joint pain is not specifically associated with the ototoxic or nephrotoxic mechanisms of action characteristic of aminoglycosides. Choice C rationale Increased salivation is not a known adverse effect of tobramycin. Aminoglycosides primarily exert their effects on bacterial protein synthesis and can cause nephrotoxicity and ototoxicity, but they do not typically influence salivary gland function or lead to increased saliva production. Choice D rationale Bruising is not a recognized adverse effect of tobramycin. Bruising typically relates to coagulation disorders or vascular fragility. Tobramycin does not directly interfere with clotting factors or platelet function, nor does it cause capillary fragility leading to increased bruising. .