A client receives a prescription for penicillin 1.2 million units IM. The available vial is labeled, “600,000 units/mL.” How many mL should the nurse administer? (Enter numeric value only.)

Choice A Reason:

A digoxin level of 1.1 ng/mL is within the therapeutic range of 0.8 to 2.6 ng/mL. Therefore, this value does not require immediate reporting to the healthcare provider. Monitoring digoxin levels is important to avoid toxicity, but this specific level is considered safe.

Choice B Reason:

A potassium level of 3.2 mEq/L is below the normal range of 3.5 to 5.0 mEq/L. Hypokalemia (low potassium levels) can increase the risk of digoxin toxicity, as digoxin and potassium compete for the same binding sites on the Na+/K+ ATPase pump. Low potassium levels can enhance the effects of digoxin, leading to potentially dangerous cardiac arrhythmias. Therefore, this value should be reported immediately.

Choice C Reason:

A creatinine level of 0.8 mg/dL is within the normal range of 0.5 to 1.1 mg/dL. This value indicates normal kidney function, which is important for the excretion of digoxin. Therefore, this value does not require immediate reporting.

Choice D Reason:

A sodium level of 135 mEq/L is just below the normal range of 136 to 145 mEq/L. While slightly low, this value is not critically abnormal and does not pose an immediate threat. It should be monitored, but it does not require urgent reporting to the healthcare provider.

Choice A reason:

Performing a bladder scan is useful for assessing urinary retention, which can be a symptom of benign prostatic hyperplasia (BPH). However, it is not the primary method for monitoring adverse reactions to tamsulosin. Tamsulosin is an alpha-1 blocker that relaxes the muscles in the prostate and bladder neck, improving urine flow. While it can help reduce urinary retention, the primary concern with tamsulosin is its effect on blood pressure.

Choice B reason:

Monitoring blood pressure is crucial because tamsulosin can cause orthostatic hypotension, a condition where blood pressure drops significantly when a person stands up from a sitting or lying position. This can lead to dizziness, lightheadedness, and even fainting. Regular monitoring of blood pressure helps detect and manage this potential adverse reaction, ensuring the client’s safety.

Choice C reason:

Obtaining daily weights is important for monitoring fluid balance and detecting conditions like heart failure or kidney disease. However, it is not directly related to the adverse reactions of tamsulosin. The primary concern with tamsulosin is its impact on blood pressure, not fluid retention.

Choice D reason:

Assessing urine output is important for evaluating the effectiveness of tamsulosin in relieving urinary symptoms associated with BPH. However, it is not the primary method for monitoring adverse reactions. The main adverse reaction to be aware of with tamsulosin is its potential to cause orthostatic hypotension, making blood pressure monitoring the priority.