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:

Determining the presence of abdominal pain is crucial because long-term use of ibuprofen can lead to gastrointestinal issues, including ulcers and bleeding. Abdominal pain can be an early sign of these complications, and prompt identification is essential to prevent more severe outcomes. Monitoring for gastrointestinal symptoms is a key aspect of managing patients on chronic NSAID therapy.

Choice B Reason:

While palpating the volume of pedal pulses is important for assessing peripheral circulation, it is not directly related to the potential side effects of long-term ibuprofen use. This assessment is more relevant for conditions affecting blood flow, such as peripheral artery disease, rather than for monitoring ibuprofen-related complications.

Choice C Reason:

Evaluating ongoing sleep patterns can provide valuable information about the client’s overall well-being and pain management. However, it is not the most critical assessment in the context of long-term ibuprofen use. Sleep disturbances may be related to chronic pain but are not directly indicative of ibuprofen’s adverse effects.

Choice D Reason:

Assessing back pain using a numeric scale is essential for evaluating the effectiveness of pain management strategies. However, it does not address the potential adverse effects of long-term ibuprofen use. While pain assessment is important, monitoring for signs of gastrointestinal complications takes precedence in this scenario.

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.