You are instructed to administer 40 mg of methadone (Dolophine) subcutaneously for opioid detoxification. Given that you have a concentration of 30 mg/mL on hand, how much should you draw into the syringe?

Rationale for A: Hemoglobin and Hematocrit
Hemoglobin (Hgb) of 6.8 g/dL is significantly below the normal range of 12-16 g/dL for women and 14-18 g/dL for men. This indicates severe anemia, which can cause several of the patient's reported symptoms, including shortness of breath, fatigue, dizziness, and intolerance to cold. It's crucial to address this promptly as severe anemia can lead to tissue hypoxia and organ damage.
Hematocrit (Hct) of 21.2% is also below the normal range of 36-46% for women and 41-50% for men. Hct measures the percentage of red blood cells in the blood, and its low value further confirms the presence of anemia.

Rationale for B: Blood Pressure 100/68, Respirations 24
Blood pressure of 100/68 mmHg is considered low, especially in a patient with a history of hypertension. This could be due to the anemia, as low red blood cell count can decrease blood volume and subsequently lower blood pressure. It's essential to monitor the patient's blood pressure closely, as hypotension can lead to dizziness, fainting, and even shock.
Respirations of 24 breaths per minute are slightly elevated above the normal adult range of 12-20 breaths per minute. This could be a compensatory mechanism for the anemia, as the body tries to increase oxygen intake. However, it could also indicate other underlying respiratory issues that need to be investigated.

Rationale for F: Shortness of breath with exertion
Shortness of breath (dyspnea) is a common symptom of anemia, as the body struggles to deliver enough oxygen to tissues during physical activity. This symptom warrants immediate attention, as it can significantly impact the patient's quality of life and could potentially signal worsening anemia or other cardiopulmonary problems.

Rationale for G: Dizziness when standing
Dizziness upon standing (orthostatic hypotension) is a sign of low blood pressure, which can be exacerbated by anemia. This can increase the risk of falls and injuries, especially in a patient with other health conditions. It's crucial to address this symptom to prevent potential complications.

Choice A rationale:
Planning activities to prevent fatigue is a valid self-care strategy for SLE patients. Fatigue is a common symptom of SLE, and it can be exacerbated by overexertion. By planning activities and pacing themselves, patients can help to manage their fatigue and conserve energy.
Fatigue management strategies include:
Prioritizing tasks and delegating when possible.
Breaking down large tasks into smaller, more manageable ones. Taking frequent rest breaks throughout the day.
Maintaining a regular sleep schedule. Engaging in moderate exercise, as tolerated.
Avoiding caffeine and alcohol, which can interfere with sleep.
Addressing any underlying health conditions that may be contributing to fatigue, such as anemia or depression.
Choice B rationale:
Prioritizing rest is another essential self-care strategy for SLE patients. Rest allows the body to conserve energy and repair itself. Patients with SLE may need more rest than healthy individuals, especially during flares.
Resting strategies include:
Getting enough sleep at night. Napping during the day, as needed.
Taking breaks from activities throughout the day.
Practicing relaxation techniques, such as deep breathing or meditation.
Choice C rationale:
Sunbathing is not recommended for SLE patients, as it can trigger flares. Ultraviolet (UV) radiation from the sun can damage skin cells and exacerbate inflammation in SLE patients. This can lead to a flare-up of symptoms, such as skin rash, joint pain, and fatigue.
Sun protection strategies include:
Avoiding direct sunlight, especially during the middle of the day when UV rays are strongest. Wearing protective clothing, such as long-sleeved shirts, pants, and wide-brimmed hats.
Using sunscreen with an SPF of 30 or higher on a daily basis.
Applying sunscreen liberally and reapplying it every two hours, or more often if sweating or swimming.
Choice D rationale:
Avoiding direct sunlight is a correct self-care strategy for SLE patients.