The nurse is providing care for an 82-year-old man whose signs and symptoms of Parkinson’s disease have worsened over the past several months.
The man states that he can no longer do as many things for himself as he used to be able to. What factor should the nurse recognize as impacting the client’s life most significantly?

Step 1: We are instructed to administer tobramycin 35mg IM every 8 hours. The available supply is 40mg in a 1 mL vial.

Step 2: We need to find out how many mL’s should the nurse administer. Step 3: We can set up a proportion to solve this.

Step 4: If 40mg is equivalent to 1mL, then 35mg is equivalent to x mL. Step 5: Solving for x gives us x = (35mg ÷ 40mg) × 1mL.

Step 6: Calculating the above expression gives us x = 0.875 mL.

Step 7: Rounding our answer to the nearest tenth, we get 0.9 mL. So, the nurse should administer 0.9 mL.

Choice A rationale
Triptans, a class of medications commonly used to treat migraines, can cause vasoconstriction, or narrowing of the blood vessels. This can be problematic for patients with angina, a condition characterized by reduced blood flow to the heart. Vasoconstriction could potentially exacerbate this condition, leading to an increased risk of a heart attack. Therefore, the use of triptans may be contraindicated in patients with angina.

Choice B rationale
While asthma is a serious condition that requires careful management, it is not typically considered a contraindication for the use of triptans. Triptans work primarily on the blood vessels in the brain and do not typically interact with the bronchial tubes affected by asthma.
Choice C rationale
Age alone is not typically a contraindication for the use of triptans. However, older adults may have a higher risk of certain health conditions, such as heart disease, which could make the use of triptans more risky. It’s important for healthcare providers to consider the overall health status of the patient, not just their age, when deciding whether to prescribe triptans.
Choice D rationale
While stress can certainly exacerbate migraines, it is not typically a contraindication for the use of triptans. Triptans are designed to relieve the pain and other symptoms of migraines, regardless of their cause. If a patient’s migraines are triggered by stress, it may be beneficial to explore stress management techniques in addition to medication.