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A client with an acute stroke must receive Alteplase 0.9 mg/kg. The client weighs 220 pounds. How should the client receive? (Round to the nearest whole number, do not use trailing zeros)

Answer and Explanation

The Correct Answer is ["90"]

Given:

Ordered dose of Alteplase: 0.9 mg/kg

Client weight: 220 pounds

Step 1: Convert the client's weight from pounds to kilograms:

1 pound (lb) = 0.453592 kilograms (kg)

Client weight in kg = 220 lbs x 0.453592 kg/lb = 99.76824 kg

Step 2: Calculate the total dose of Alteplase:

Total dose (mg) = Ordered dose (mg/kg) xClient weight (kg)

Total dose (mg) = 0.9 mg/kg x 99.76824 kg

Total dose (mg) = 89.801416 mg

Step 3: Round to the nearest whole number:

Total dose (mg) ≈ 90 mg

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Correct Answer is B

Explanation

A) IM epinephrine is the fastest route of administration:
While epinephrine is often administered intramuscularly in cases of anaphylaxis and allergic reactions, the speed of action is not the primary reason for choosing this route over intravenous (IV) administration in this situation. Intramuscular administration of epinephrine allows for a rapid onset of action, but it is not necessarily the fastest route compared to IV. IV administration would act more quickly in an emergency setting where immediate blood circulation is critical, but IM is preferred in allergic reactions to prevent excessive systemic effects and to avoid rapid peaks in plasma levels.

B) IV epinephrine is only administered during cardiac arrest:
Epinephrine is generally administered intravenously during life-threatening situations such as cardiac arrest or severe shock, where immediate circulatory effects are needed. In cases of anaphylaxis, however, intramuscular (IM) administration of epinephrine is the preferred route because it allows for a more controlled absorption rate and reduces the risk of excessive blood pressure and other adverse cardiovascular effects. This is the correct rationale for why epinephrine is administered IM in the context of an allergic reaction.

C) Epinephrine would not be administered in this situation:
Epinephrine is the first-line treatment for severe allergic reactions and anaphylaxis, especially in cases where symptoms like wheezing, shortness of breath, urticaria, and itching are present. Therefore, withholding epinephrine is not an appropriate response in this situation. Immediate intervention with epinephrine is critical to reverse the symptoms of anaphylaxis and prevent further respiratory distress or cardiovascular collapse.

D) IM epinephrine is less concentrated than IV:
The concentration of epinephrine used for IM and IV administration is the same. The primary reason for choosing the IM route over the IV route is the slower absorption and the fact that it minimizes the risk of a rapid increase in systemic blood pressure and other adverse reactions. While IM epinephrine may be absorbed more slowly than IV, its concentration is appropriate for treating anaphylaxis effectively. The choice of IM is based on safety and controlled response, not on the concentration of the drug.

A. single color throughout B. diameter smaller than 2mm. C. has uneven or irregular borders. D. Is symmetrical in shape."

Correct Answer is C

Explanation

A) Single color throughout:
A mole that is a single, consistent color is typically not a concern for melanoma. However, one of the key warning signs of melanoma is a mole that has multiple colors or shades, such as tan, brown, black, or even red or blue. The presence of more than one color in a mole can indicate melanoma, and the client should be advised to seek medical attention if the mole has varied colors.

B) Diameter smaller than 2mm:
A mole that is smaller than 2mm in diameter is typically not a concern for melanoma. Melanomas are often larger than 6mm in diameter, about the size of a pencil eraser, though smaller melanomas can also occur. A mole smaller than 2mm is usually considered benign, but any change in size, shape, or color, regardless of the starting size, should be evaluated.

C) Has uneven or irregular borders:
One of the primary warning signs of melanoma is the presence of irregular or uneven borders on a mole. Normal moles typically have smooth, even borders, while moles with jagged, blurred, or irregular edges are more likely to be melanoma. The client should seek medical attention if they notice any moles with irregular borders, as this could be a sign of malignancy.

D) Is symmetrical in shape:
A mole that is symmetrical (both halves are the same size and shape) is generally not a concern for melanoma. In contrast, asymmetry (when one half of the mole does not match the other half) is a key warning sign for melanoma. A mole that lacks symmetry should be evaluated by a healthcare provider.

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A client with an acute stroke must receive Alteplase 0.9 mg/kg. The client weighs 220 pounds. How should the client receive? (Round to the nearest whole number, do not use trailing zeros)

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Explanation

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