A client with chronic kidney disease receives a prescription for darbepoetin alfa 40 mcg subcutaneous every 7 days.

The darbepoetin alfa vial is labeled, "60 mcg/mL." How many mL should the nurse administer? round to the nearest tenth.

• A bowel patern is the frequency, consistency, and appearance of a person's bowel movements. A normal bowel patern is what's normal for each person, and it can vary depending on factors such as diet, age, physical activity, and health conditions.
• A focused gastrointestinal system assessment includes collecting subjective data about the patient's history of gastrointestinal disease, signs and symptoms of gastrointestinal problems, diet and nutrition, and bowel patern. It also includes inspecting and auscultating the abdomen for any abnormalities³.
• When a client reports having a bowel movement three days ago, the first action that the practical nurse should implement is to determine the client's usual bowel patern. This will help to evaluate if the client is experiencing constipation or if this is their normal frequency. It will also help to identify any changes or risk factors that may affect the client's bowel function.

Therefore, option B is the correct answer, while options A, C, and D are incorrect.

Option A is incorrect because administering a stool softener without assessing the client's bowel patern may not be appropriate or effective.

Option C is incorrect because encouraging ambulation may help to stimulate bowel activity, but it is not the first action to take.

Option D is incorrect because recommending dietary changes may be helpful for preventing or treating constipation, but it is not the first action to take.

Choice A rationale:

Provide a safe and calm environment for the client during a panic attack. Creating a safe and calm environment is crucial during a panic attack. It can help the client feel more secure and reduce the intensity and duration of the panic attack.

Choice B rationale:

Use therapeutic communication skills to establish rapport and trust with the client. Therapeutic communication is essential for clients with panic disorder. It helps establish a trusting relationship between the nurse and the client, which is crucial for effective treatment and support.

Choice C rationale:

Educate the client about panic disorder and its treatment options. Educating the client about their condition and available treatment options empowers them to make informed decisions about their care. It also reduces anxiety and fear associated with the disorder.

Choice D rationale:

Encourage the client to participate in cognitive-behavioral therapy (CBT). Cognitive-behavioral therapy is a well-established and effective treatment for panic disorder. Encouraging the client to participate in CBT can help them develop coping strategies and manage their symptoms.

Choice E rationale:

Refer the client to self-help groups for peer support and education. Self-help groups can provide valuable peer support and education to individuals with panic disorder. Being part of such a group can reduce feelings of isolation and provide practical advice for managing the condition.