A nurse is preparing to administer vancomycin to a client who has an infected wound. The nurse should plan to monitor for which of the following adverse reactions?

A. Hepatotoxicity: Vancomycin is not commonly associated with liver toxicity. While liver function may be monitored in clients receiving multiple medications, hepatotoxicity is not a primary concern with vancomycin therapy. B. Ototoxicity: Vancomycin can cause ototoxicity, particularly with high doses or prolonged therapy. This adverse effect may present as tinnitus or hearing loss, making it important for the nurse to monitor the client’s auditory function during treatment. C. Hypercalcemia: Vancomycin does not affect calcium metabolism, so hypercalcemia is not an expected adverse reaction. Monitoring calcium levels is not routinely necessary for vancomycin administration. D. Hypertension: Hypertension is not a known adverse effect of vancomycin. Blood pressure monitoring is standard for overall care, but vancomycin itself does not typically cause elevations in blood pressure.