A nurse is preparing to administer voriconazole 6 mg/kg via intermittent IV bolus to a client who weighs 127 lb. Available is voriconazole 5 mg/mL. How many mL should the nurse administer?
(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

To calculate the amount of tobramycin that the nurse should administer per dose, we can use the following steps:

Calculate the total daily dosage required based on the client's weight and the prescribed dosage.

Determine the dosage per each of the three divided doses.

Calculate the volume of the drug needed for each dose using the concentration of the available tobramycin solution.

Given:

Client's weight = 85 kg

Prescribed dosage = 3 mg/kg/day

Available concentration of tobramycin = 40 mg/mL

Let's calculate step by step:

Calculate the total daily dosage required:

Total daily dosage = 3 mg/kg/day × 85 kg = 255 mg/day

Determine the dosage per each of the three divided doses:

Dosage per dose = Total daily dosage / 3 = 255 mg / 3 = 85 mg

Calculate the volume of the drug needed for each dose using the concentration of the available tobramycin solution:

Volume of drug per dose = Dosage per dose / Concentration of tobramycin

Volume of drug per dose = 85 mg / 40 mg/mL ≈ 2.1 mL

Rounding to the nearest tenth, the nurse should administer 2.1 mL of the tobramycin per dose.

Choice A reason: This choice is correct because captopril is an angiotensin-converting enzyme (ACE) inhibitor that can cause fetal harm or death if used during pregnancy. Captopril can affect the development of the baby's kidneys, lungs, skull, and blood vessels. The nurse should advise the patient to use effective contraception while taking captopril and to inform the provider as soon as possible if she becomes pregnant or plans to become pregnant. The provider may switch the patient to a safer medication for blood pressure control during pregnancy.

Choice B reason: This choice is incorrect because facial swelling is a serious side effect of captopril that may indicate angioedema, a life-threatening allergic reaction that causes swelling of the face, lips, tongue, throat, or airway. The nurse should instruct the patient to stop taking captopril and seek emergency medical attention if she develops facial swelling or any signs of difficulty breathing, such as wheezing, stridor, or cyanosis. Reducing the dose of captopril will not prevent or treat angioedema.

Choice C reason: This choice is incorrect because captopril can be taken with or without food, depending on the patient's preference and tolerance. Food may decrease the absorption of captopril, but this effect is not clinically significant for most patients. The nurse should advise the patient to take captopril at the same time each day, preferably one hour before meals, to maintain consistent blood levels and effects.

Choice D reason: This choice is incorrect because captopril is unlikely to cause anaphylaxis, a severe and potentially fatal allergic reaction that involves multiple organ systems. Anaphylaxis can cause symptoms such as hives, itching, flushing, swelling, nausea, vomiting, diarrhea, abdominal pain, low blood pressure, fast heart rate, and shock. The nurse should instruct the patient to carry an epi pen only if she has a history of anaphylaxis or a severe allergy to another substance. .