A client receives a prescription for dalteparin 2500 units subcutaneously 2 hours before a scheduled procedure. The medication is available in a 5000 units/0.2 mL prefilled syringe. How many mL should the nurse administer? (Enter numeric value only)

Choice A reason: Notifying the healthcare provider of the carbamazepine level is not necessary, as 8.4 mg/L (35.6 mcmol/L) is within

the normal range of 4 to 12 mg/L (16.9 to 50.8 mcmol/L). The healthcare provider may adjust

the dose based on other factors such as clinical response, seizure frequency, or adverse effects,

but not based on this level alone.

Choice B reason: Administering the carbamazepine as prescribed is the appropriate action to take, as 8.4 mg/L (35.6 mcmol/L) is within

the normal range of 4 to 12 mg/L (16.9 to 50.8 mcmol/L). The nurse should follow the prescribed

dose and schedule of carbamazepine to maintain a therapeutic level and prevent seizures.

Choice C reason: Assessing the client for side effects of carbamazepine is important, as carbamazepine can cause adverse effects such as drowsiness, dizziness, nausea, rash, or blood dyscrasias. However, this action is not related to the carbamazepine level, as side effects can occur at any level and may not correlate with the serum concentration. The nurse should monitor the client for side effects regardless of the carbamazepine level.

Choice D reason: Withholding this dose of carbamazepine is not appropriate, as 8.4 mg/L (35.6 mcmol/L) is withinthe normal range of 4 to 12 mg/L (16.9 to 50.8 mcmol/L). Withholding the dose may cause a drop in the serum concentration and increase the risk of seizures. The nurse should administer the carbamazepine as prescribed unless instructed otherwise by the healthcare provider.

Choice A reason: This is the best option to measure the peak and trough levels of vancomycin, as it reflects the highest and lowest concentrations of the drug in the blood. The peak level indicates the efficacy and potential toxicity of vancomycin, while the trough level indicates the clearance and potential subtherapeutic effect of vancomycin. The peak level should be drawn immediately after completion of the IV dose, as it takes about 30 minutes for vancomycin to reach its maximum concentration in the blood. The trough level should be drawn 30 minutes before the next administration of the medication, as it represents the lowest concentration of vancomycin in the blood before it is replenished by another dose.

Choice B reason: This is not a good option to measure the peak and trough levels of vancomycin, as it may not capture the true highest and lowest concentrations of the drug in the blood. The peak level may be lower than expected, as it takes about 30 minutes for vancomycin to reach its maximum concentration in the blood. The trough level may be higher than expected, as it is drawn too close to the next administration of the medication.

Choice C reason: This is not a good option to measure the peak and trough levels of vancomycin, as it does not reflect the highest and lowest concentrations of the drug in the blood. The peak level is drawn too early, as vancomycin has not reached its maximum concentration in the blood yet. The trough level is drawn too late, as vancomycin has already started to decline in the blood.

Choice D reason: This is not a good option to measure the peak and trough levels of vancomycin, as it may miss the highest and lowest concentrations of the drug in the blood. The peak level is drawn too late, as vancomycin may have already started to decline in the blood. The trough level is drawn too early, as vancomycin may have not reached its minimum concentration in the blood yet.