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?

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.

Choice A rationale:

Providing written pamphlets for instruction can be a useful supplement, but it may not be the most effective method for teaching a skill like self-injection of insulin. This is because it lacks the hands-on practice and immediate feedback that can be crucial for learning a new physical skill.

Choice B rationale:

After demonstrating the procedure, allowing the patient to do several return demonstrations is considered one of the best methods for teaching a skill like self-injection of insulin. This approach, often referred to as “see one, do one, teach one,” allows the patient to observe the correct technique, practice it themselves, and then demonstrate their understanding by teaching it back. This method is particularly effective because it engages the patient in active learning and provides opportunities for immediate feedback and correction.

Choice C rationale:

Showing a video and allowing the patient to practice as needed on his own can be helpful, but it may not be as effective as other methods. This is because it lacks the immediate feedback and personalized instruction that can be provided in a one-onone teaching session. Additionally, practicing “as needed” may not provide the consistent repetition needed to master a new skill.

Choice D rationale:

Verbally explaining the procedure and providing written handouts for reinforcement can be effective, but it may not be sufficient for teaching a skill like self-injection of insulin. This is because it lacks the hands-on practice that is crucial for learning a new physical skill. Additionally, relying solely on verbal explanation and written handouts may not address all learning styles.