A patient who is HIV-positive has been receiving medication therapy that includes zidovudine.

The prescriber has decided to stop the zidovudine due to its dose-limiting adverse effect.

Which of these conditions is the dose-limiting adverse effect of zidovudine therapy?

Choice A rationale:

A WBC count of 16,000/mm is higher than the normal range of 5,000 to 10,000 cells/mm. This indicates that the body is fighting an infection, which is a common reason for prescribing Vancomycin. Therefore, a high WBC count could indicate a therapeutic response to the medication as it suggests that the body’s immune system is actively fighting the infection.

Choice B rationale:

A BUN level of 42 mg/dl is higher than the normal range of 7 to 20 mg/dL3456. Elevated BUN levels can indicate kidney damage or disease, which is not a desired therapeutic response to Vancomycin. Vancomycin can be nephrotoxic, and its use requires careful monitoring of kidney function. Therefore, a high BUN level does not indicate a therapeutic response to the medication. Choice C rationale:

A blood pressure reading of 95/64 is considered normal. Maintaining normal blood pressure is important for overall health and can indicate that the patient’s body is responding well to the medication. Therefore, a blood pressure reading within the normal range could indicate a therapeutic response to Vancomycin.

Choice D rationale:

A body temperature of 101.8F is considered a fever14. Fever is a common response to infection and can indicate that the body is fighting off an infection, which is a common reason for prescribing Vancomycin. Therefore, a high body temperature could indicate a therapeutic response to the medication as it suggests that the body’s immune system is actively fighting the infection.

The correct answer is Choice C.

Let’s go through the calculation step by step:

Step 1: Identify the order and the available medication. The order is for dexamethasone (Decadron) 6mg IM. The available stock is dexamethasone 4mg/1ml in a 5ml multidose vial.

Step 2: Determine the amount of medication needed to fulfill the order. This is done by dividing the ordered amount by the concentration of the available medication.

So, we have:

Step 2 Calculation=Concentration of Available MedicationOrdered Amount Substituting the given values: Step 2 Calculation=4 mg/mL6 mg Step 3: Perform the calculation.

Step 3 Calculation=1.5 mL

So, the nurse will prepare 1.5 mL of this medication.

Now, let’s discuss the rationales for each choice:

Choice A rationale:

75 mLs is not the correct amount. This would be a significantly larger dose than ordered, which could lead to an overdose.

Choice B rationale:

5 mLs is not the correct amount. This would also be a larger dose than ordered, which could lead to an overdose.

Choice C rationale:

1.5 mLs is the correct amount. This is calculated by dividing the ordered dose (6 mg) by the concentration of the available medication (4 mg/mL).

Choice D rationale:

15 mLs is not the correct amount. This would be a significantly larger dose than ordered, which could lead to an overdose.