A nurse is preparing to administer darbepoetin 0.45 mcg/kg subcutaneous once weekly to a client who weighs 198 lb. The amount available is Darbepoetin 300 mcg/mL. How many mL should the nurse administer?
(Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Choice A reason: Age is a non-modifiable risk factor for hypertension because the risk of high blood pressure increases as we get older. This is due to changes in the heart and blood vessels, such as loss of elasticity and stiffening of the arteries, that affect the blood flow and pressure. ¹

Choice B reason: Genetics is a non-modifiable risk factor for hypertension because some people inherit genes that make them more likely to develop high blood pressure. For example, people of African and Black Caribbean descent have a higher risk of hypertension due to genetic variations that affect salt sensitivity and blood vessel function. ²

Choice C reason: Smoking is a modifiable risk factor for hypertension because it can be changed or avoided by quitting tobacco use. Smoking damages the blood vessels and increases the risk of atherosclerosis, which is the buildup of plaque in the arteries that narrows them and raises blood pressure. Smoking also lowers the level of good cholesterol (HDL) and raises the level of bad cholesterol (LDL) and triglycerides, which are fats in the blood that contribute to plaque formation. ³

Choice D reason: Obesity is a modifiable risk factor for hypertension because it can be changed or prevented by losing weight or maintaining a healthy weight. Obesity increases the risk of high blood pressure by putting extra strain on the heart and blood vessels, as well as by causing hormonal and metabolic changes that affect blood pressure regulation. Obesity is also associated with other conditions that can raise blood pressure, such as diabetes, sleep apnea, and kidney disease. ⁴

Choice E reason: Sedentary lifestyle is a modifiable risk factor for hypertension because it can be changed or improved by increasing physical activity. Sedentary lifestyle increases the risk of high blood pressure by reducing the ability of the blood vessels to dilate and contract, as well as by increasing the risk of obesity, diabetes, and high cholesterol. Physical activity helps to lower blood pressure by improving blood flow, strengthening the heart muscle, and lowering body weight and stress levels. .

Choice A reason: How to check apical heart rate is not a priority education for this client. Apical heart rate is the number of heartbeats per minute that can be heard at the apex of the heart. It can be used to monitor the effect of cardiac medications, such as atenolol or digoxin. This client is taking atenolol, but the nurse can check the client's radial pulse (at the wrist) instead of the apical pulse, unless there is a discrepancy or an irregular rhythm. The nurse should teach the client how to check their radial pulse and report any changes or symptoms.

Choice B reason: Signs and symptoms of hypothyroidism are not a priority education for this client. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones, which regulate the metabolism and energy of the body. Hypothyroidism can cause symptoms such as fatigue, weight gain, cold intolerance, dry skin, hair loss, and depression. This client is not taking any medication that affects the thyroid function, and there is no evidence of hypothyroidism in the client's history or labs. The nurse should assess the client's thyroid function and teach the client about the signs and symptoms of thyroid disorders.

Choice C reason: Bleeding precautions are a priority education for this client. Bleeding precautions are measures to prevent or minimize bleeding in clients who are at risk of bleeding, such as those who are taking anticoagulants, have low platelets, or have bleeding disorders. This client is taking warfarin, an anticoagulant that increases the risk of bleeding.

Choice D reason: Increasing potassium rich foods in the diet is not a priority education for this client. Potassium is a mineral that helps regulate the fluid balance, nerve impulses, and muscle contractions in the body. Potassium levels can be affected by medications, such as diuretics, ACE inhibitors, or potassium supplements. This client is taking captopril, an ACE inhibitor that can increase the potassium level in the blood. The client's potassium level is normal (4.8 mmol/L), and there is no need to increase the intake of potassium rich foods, such as bananas, oranges, potatoes, tomatoes, or beans. The nurse should monitor the client's potassium level and teach the client about the signs and symptoms of high or low potassium, such as muscle weakness, cramps, irregular heartbeat, or numbness.