A client with hypertension currently takes two and a half tablets of bisoprolol per day, each containing 100 mg. The new order is 500 mg of bisoprolol per day.
What instruction should be given to this client for the effective management of hypertension?

To answer this question, the nurse needs to perform the following steps:

1) Convert the patient's weight from pounds and ounces to kilograms, using the conversion factor of 1 pound = 0.45359237 kilograms¹². To do this, first convert the ounces to a fraction of a pound by dividing by 16, then add this fraction to the pounds, and then multiply by the conversion factor. For example:

7 lb, 11.2 oz = 7 + (11.2 / 16) lb
= 7.7 lb
= 7.7 × 0.45359237 kg
= 3.492 kg

2) Calculate the dose of Garamycin in milligrams, using the prescribed dose of 4 mg/kg and the patient's weight in kilograms. To do this, simply multiply the dose per kilogram by the weight in kilograms. For example:

4 mg/kg × 3.492 kg = 13.968 mg

3) Calculate the volume of Garamycin in milliliters, using the reconstituted dosage of 20 mg/10 mL and the dose in milligrams. To do this, use a proportion to find the unknown volume that corresponds to the known dose. For example:

20 mg / 10 mL = 13.968 mg / x mL Cross-multiply and solve for x: 20x = 139.68

x = 6.984 mL
x =7 mL

To find the maximum number of tablets the patient may have in 24 hours, you need to calculate the following:

- The number of doses the patient may have in 24 hours using the formula: Number of doses = 24 hours / Dosing interval (hours)
- The total dose of ibuprofen in milligrams (mg) for 24 hours using the formula: Total dose (mg) = Number of doses x Prescribed dose (mg)
- The number of tablets of ibuprofen using the formula: Number of tablets = Total dose (mg) / Strength per tablet (mg)

First, use the formula for number of doses to find how many times the patient may take ibuprofen in 24 hours:

Number of doses = 24 hours / Dosing interval (hours)

Since the dosing interval is 6 hours, plug in this value into the formula:

Number of doses = 24 hours / 6 hours

Simplify and solve for the number of doses:

Number of doses = 4

Next, use the formula for total dose to find the amount of ibuprofen in milligrams for 24 hours:

Total dose (mg) = Number of doses x Prescribed dose (mg)

Since the number of doses is 4 and the prescribed dose is 600 mg, plug in these values into the formula:

Total dose (mg) = 4 x 600 mg

Simplify and solve for the total dose:

Total dose (mg) = 2400 mg

Then, use the formula for number of tablets to find how many tablets of ibuprofen are needed:

Number of tablets = Total dose (mg) / Strength per tablet (mg)

Since the total dose is 2400 mg and the strength per tablet is 200 mg, plug in these values into the formula:

Number of tablets = 2400 mg / 200 mg

Simplify and solve for the number of tablets:

Number of tablets = 12

Therefore, the maximum number of tablets the patient may have in 24 hours is **12**.