A client who is admitted with late symptoms of HIV disease is receiving zidovudine 0.2 grams every 4 hours. The medication is provided in suspension of 50 mg per 5 mL. How many mL should the nurse administer? (Enter numeric value only.)

Calculation:

Desired dose = 10 mcg.

• Convert the desired dose from micrograms (mcg) to milligrams (mg) to match the available concentration's unit.

Since 1 mg = 1000 mcg,

Desired dose in mg = 10 mcg / 1000 mcg/mg

= 0.01 mg.

Available concentration = 0.02 mg/mL.

• Calculate the volume to administer.

Volume (mL) = Desired dose (mg) / Available concentration (mg/mL)

= 0.01 mg / 0.02 mg/mL

= 0.5 mL.

• Myocardial infarction (MI): The client reports chest pain rated 8/10, radiating to the left arm, and has ST segment elevation on ECG. These findings are classic for ST-elevation myocardial infarction (STEMI), requiring immediate intervention.
• Draw laboratory cardiac markers: Troponin and other cardiac enzymes are critical for confirming myocardial injury. They help guide diagnosis, treatment, and monitoring of MI progression or resolution.
• Insert two peripheral IV (PIV) access devices: Dual IV access ensures reliable and rapid administration of emergency medications, fluids, or thrombolytics. This is vital for stabilizing the client during acute cardiac events.
• Pain level: Ongoing pain assessment is essential for monitoring myocardial ischemia, evaluating treatment response, and guiding further interventions to prevent cardiac tissue damage.
• 12-lead electrocardiogram (ECG): Continuous or repeated ECGs help detect changes in ST segments, arrhythmias, or infarct progression. It’s crucial in monitoring the effectiveness of interventions and early detection of complications.

• Reflux: While reflux may cause chest discomfort, it is not associated with ST elevation or arm radiation. These findings are cardiac in nature and point away from gastrointestinal causes.
• Costochondritis: This musculoskeletal condition causes localized chest pain but does not result in ECG changes or radiating pain. It is not supported by the client's data.
• Atrial fibrillation (A-fib): The client has a normal heart rate and regular rhythm. A-fib would show an irregular rhythm on ECG, not ST elevation, and is not the suspected diagnosis here.
• Insert nasogastric tube (NGT) for nutritional intake: An NGT is not a priority for a client with acute chest pain. The focus should be on stabilizing cardiac function rather than nutritional support.
• Consult nutritionist: Nutritional counseling may be relevant later, but it is not an acute intervention during a suspected myocardial infarction.
• Begin strict bedrest: While activity should be limited, “strict bedrest” is not always necessary and may lead to complications like DVT. The client’s mobility orders depend on cardiac stability.
• Intake and output: While important in general care, it is not as immediately critical in early MI management as pain and ECG monitoring.
• Nutritional intake: Nutritional monitoring is not an immediate priority during acute chest pain evaluation and cardiac stabilization.
• Peripheral edema: Edema may indicate chronic heart failure, but it is not a key indicator for acute myocardial infarction or urgent follow-up in this scenario.