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In this scenario, acute tubular necrosis (ATN) is the most likely condition to suspect. Gentamicin is an antibiotic known to be nephrotoxic, especially when used in higher doses or for extended periods. The drug can cause damage to the renal tubules, leading to decreased kidney function and, consequently, oliguria, which is the reduction in urine output.

The elevated lab values, commonly including creatinine and blood urea nitrogen (BUN), further indicate impaired renal function. In ATN, the tubular cells are damaged, and their ability to reabsorb water and electrolytes is compromised, which explains the oliguria.

While dehydration could explain oliguria and elevated lab values, it would not typically be associated specifically with gentamicin use. Gastrointestinal infections or chronic renal failure would present differently and would not directly correlate with acute changes following the administration of this medication. Thus, considering the context of recent medication use and the specific symptoms, acute tubular necrosis is the appropriate conclusion.