A nurse is completing discharge teaching to a patient who has seizures and received a vagal nerve stimulator to decrease seizure activity. Which of the following statements should the nurse include in the teaching?

Step 1: Determine the desired dose in mL.

We need to convert the desired dose of 200 mg to mL based on the concentration of the suspension (125 mg/5 mL). We can achieve this using the following proportion:

Desired dose (mg) / Concentration (mg/mL) = Volume (mL) Step 2: Perform the calculation.

Substituting the known values:

200 mg / 125 mg/mL = Volume (mL) Solving for the volume:

Volume = 200 mg / 125 mg/mL

Volume ≈ 1.6 mL

Step 3: Round the answer to a whole number, considering clinical practice.

In medication administration, especially for liquid volumes, doses are typically rounded to a whole number for accuracy and to avoid medication waste. Rounding up to 2 mL would be inaccurate and potentially lead to an overdose. Therefore, we round down to the nearest whole number, which is 1 mL.

Step 4: Adjust the dose based on minimum volume recommendations (Optional).

Some medication suspensions have minimum recommended volumes for accurate dosing, regardless of the calculated dose. Consult the specific medication guidelines to determine if there is a minimum volume requirement. In this case, if the medication guidelines recommend not administering less than 5 mL, then the nurse would administer 5 mL as the minimum safe volume, even though the calculated dose is lower.

Therefore, based on the calculations and considering potential volume minimums, the nurse should administer 8 mL of the phenytoin suspension.

Choice A rationale:
Flu-like symptoms: These are common during the early stages of HIV infection, often within 2-4 weeks after exposure to the virus. They are a result of the body's immune system responding to the virus. Symptoms can include:
Fever Fatigue

Muscle aches

Headache Sore throat

Rash

Swollen lymph nodes
Night sweats: These are also common in early HIV infection and can be caused by the body's attempts to fight off the virus or by inflammation. They can also be a side effect of some HIV medications.

Choice B rationale:
Kaposi's sarcoma (KS): This is a type of cancer that is associated with HIV infection. It is caused by a virus called Kaposi's sarcoma-associated herpesvirus (KSHV). KS often appears as purple or red lesions on the skin or in the mouth. It can also affect other organs, such as the lungs and lymph nodes. However, it's not a common initial symptom of HIV infection. It usually develops in later stages of HIV when the immune system is severely weakened.

Choice C rationale:
Fungal and bacterial infections: People with HIV are more susceptible to infections because the virus weakens their immune system. However, fungal and bacterial infections are not typically among the initial symptoms of HIV infection. They usually occur in later stages of the disease when the immune system is more compromised.

Choice D rationale:
Pneumocystis lung infection (PCP): This is a serious lung infection that is caused by a fungus called Pneumocystis jirovecii. It is a common opportunistic infection in people with HIV, but it is not typically an initial symptom. It usually develops in later stages of HIV when the CD4 count (a measure of immune system health) is very low.