The nurse would recognize which of the following as non-modifiable risk factors for hypertension? SELECT ALL THAT APPLY

Choice A reason: This choice is incorrect because insulin is not commonly given to all hospitalized clients. Insulin is a hormone that lowers blood sugar levels in the body. It is only given to clients who have diabetes or other conditions that cause high blood sugar, such as pancreatitis, sepsis, or steroid therapy. The nurse should explain the indication and purpose of insulin to the client and not make false or misleading statements.

Choice B reason: This choice is incorrect because the client did not likely develop diabetes prior to hospitalization, but are just now being diagnosed. Diabetes is a chronic condition where the body either does not produce enough insulin or does not use it properly, resulting in high blood sugar levels. Diabetes can be diagnosed by measuring the blood sugar levels, the hemoglobin A1c levels, or the oral glucose tolerance test. The nurse should not assume or imply that the client has diabetes without proper testing and confirmation.

Choice C reason: This choice is incorrect because the client did not develop type 1 diabetes and will not need insulin for the rest of their life. Type 1 diabetes is an autoimmune condition where the body destroys the insulin-producing cells in the pancreas, leading to a complete lack of insulin. Type 1 diabetes usually develops in childhood or adolescence, and requires lifelong insulin therapy. The nurse should not diagnose or predict the client's condition without evidence or authority.

Choice D reason: This choice is correct because glucocorticoid steroid medications can cause temporary hyperglycemia. Glucocorticoids are anti-inflammatory drugs that suppress the immune system and reduce inflammation. They are used to treat conditions such as multiple sclerosis, asthma, rheumatoid arthritis, and allergic reactions. However, they can also increase the blood sugar levels by stimulating the liver to produce more glucose and reducing the sensitivity of the cells to insulin. The nurse should inform the client that the insulin is needed to control the blood sugar levels while they are on steroid therapy, and that the insulin dose may be adjusted or discontinued when the steroids are tapered or stopped.

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.