A patient has been admitted with a fever of 102.8 F (39.3 C), with an unknown origin.

The patient’s urine is cloudy, foul-smelling, and dark amber.

Orders have been given to obtain urine and blood cultures immediately and to administer an antibiotic intravenously.

In what order should the nurse complete these orders?

The question is about calculating the volume of phenytoin oral solution that the nurse should administer per dose. The client is prescribed 250 mg of phenytoin and the available solution has a concentration of 25 mg/5 mL.

Let’s calculate the volume step by step:

Step 1: Identify the prescribed dose and the concentration of the available medication. The prescribed dose is 250 mg and the concentration of the available medication is 25 mg/5 mL.

Step 2: Set up the calculation. We want to find out how many mL correspond to the prescribed dose. We can set up the calculation as follows: (Prescribed dose ÷ Concentration) × Volume.

Step 3: Substitute the known values into the calculation. This gives us: (250 mg ÷ 25 mg/5 mL).

Step 4: Perform the division operation first due to the order of operations (BIDMAS/BODMAS). This gives us: (250 mg ÷ 5 mg/mL).

Step 5: Perform the final calculation. This gives us: 50 mL.

So, the nurse should administer 50 mL of the phenytoin oral solution per dose.

Please note that this calculation assumes that the prescribed dose (250 mg) is to be administered in one go. If the dose is to be split over the day, the volume to be administered would change accordingly.

Choice A rationale:

Amphotericin B is a potent antifungal medication used to treat severe fungal infections. However, it is typically reserved for life-threatening systemic fungal infections due to its potential for serious side effects, including kidney damage and infusion reactions. It is not commonly used as a first-line treatment for vaginal yeast infections.

Choice B rationale:

While antifungal creams can be effective for treating vaginal yeast infections, they typically require a treatment course of several days. This option may not be the best choice for a patient seeking a quicker, one-time treatment.

Choice C rationale:

A single dose of a fluconazole oral tablet is often an effective treatment for vaginal yeast infections. Fluconazole works by inhibiting the growth of the yeast causing the infection. It is convenient for patients because it only requires one dose, unlike creams or suppositories that need to be applied for several days.

Choice D rationale:

There are indeed alternatives to antifungal suppositories for treating vaginal yeast infections. As mentioned above, a single dose of fluconazole is one such alternative. Therefore, stating that there is no better alternative to the suppositories is not accurate.