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.)

To calculate the amount of voriconazole to be administered, we can follow these steps:

Convert the client's weight from pounds to kilograms.

Calculate the total amount of voriconazole needed based on the client's weight.

Determine the volume of the medication to be administered based on the concentration of the available solution.

Let's proceed with the calculations:

Converting the client's weight from pounds to kilograms:

Client's weight = 127 lb

1 lb ≈ 0.453592 kg

Client's weight ≈ 127 lb 0.453592 kg/lb ≈ 57.61 kg

Calculating the total amount of voriconazole needed:

Voriconazole dose = 6 mg/kg 57.61 kg ≈ 345.66 mg

Determining the volume of the medication to be administered:

Available voriconazole concentration = 5 mg/mL

Volume to be administered = 345.66 mg / 5 mg/mL ≈ 69.132 mL

Rounding to the nearest whole number, the nurse should administer 69 mL of voriconazole.

Choice A reason: Atenolol is a beta blocker that lowers blood pressure and heart rate. The nurse should hold atenolol for this client because the client's heart rate is already low (52 beats per minute), and giving atenolol could cause bradycardia (slow heart rate), which can lead to dizziness, fainting, or heart failure. The nurse should notify the provider and monitor the client's vital signs and cardiac rhythm.

Choice B reason: Captopril is an ACE inhibitor that lowers blood pressure and prevents kidney damage. The nurse should not hold captopril for this client because the client's blood pressure is still high (138/90 mmHg), and captopril could help lower it to the target range. The nurse should administer captopril as prescribed and monitor the client's blood pressure and renal function.

Choice C reason: Warfarin is an anticoagulant that prevents blood clots and reduces the risk of stroke. The nurse should not hold warfarin for this client because the client's INR (a measure of blood clotting time) is within the therapeutic range (2.0 to 3.0), and warfarin could help prevent post-operative complications such as deep vein thrombosis or pulmonary embolism. The nurse should administer warfarin as prescribed and monitor the client's INR and bleeding signs.

Choice D reason: Glipizide is not a medication for this client. Glipizide is an oral hypoglycemic agent that lowers blood sugar levels in people with diabetes. This client does not have diabetes and does not need glipizide. The nurse should check the medication order and the client's medical history and clarify any discrepancies with the provider.