A nurse is preparing to administer 4,000 units of heparin subcutaneously to a client who has deep-vein thrombosis.

Available is heparin 10,000 units/mL.

How many mL of heparin should the nurse administer? (Round the answer to the nearest) tenth.

Use a leading zero if it applies.

Do not use a trailing zero.) mL.

Drowsiness is a very common adverse effect of paroxetine, a selective serotonin reuptake inhibitor (SSRI) used to treat depression and anxiety. Paroxetine can cause somnolence (sleepiness) in up to 22% of patients who take it. The nurse should instruct the client to monitor for this effect and avoid driving or operating machinery until they know how the medication affects them.

Choice A is wrong because tinnitus (ringing in the ears) is not a common adverse effect of paroxetine.

It may occur rarely in some patients, but it is not a typical symptom of SSRI use.

Choice B is wrong because alopecia (hair loss) is not a common adverse effect of paroxetine.

It may occur rarely in some patients, but it is not a typical symptom of SSRI use.

Choice C is wrong because peripheral edema (swelling of the limbs) is not a common adverse effect of paroxetine.

It may occur rarely in some patients, but it is not a typical symptom of SSRI use.

Epinephrine (adrenaline) is the first-line treatment for anaphylaxis, a severe and potentially life-threatening allergic reaction. Epinephrine works by reducing the body’s allergic response and improving the breathing and circulation of the client. Epinephrine should be given as soon as possible after the onset of anaphylaxis symptoms, using an auto-injector device if available.

Choice B is wrong because replacing the infusion with 0.9% sodium chloride (normal saline) is not enough to treat anaphylaxis. Normal saline can help maintain the blood pressure and hydration of the client, but it does not reverse the allergic reaction or improve the breathing of the client. Normal saline can be given after epinephrine, but not before or instead of it.

Choice C is wrong because giving diphenhydramine IM is not enough to treat anaphylaxis. Diphenhydramine is an antihistamine that can help relieve some of the symptoms of anaphylaxis, such as itching and hives, but it works too slowly and does not address the more serious effects of anaphylaxis on the breathing and circulation of the client. Diphenhydramine can be given after epinephrine, but not before or instead of it.

Choice D is wrong because elevating the client's legs and feet is not enough to treat anaphylaxis. Elevating the legs and feet can help increase the blood flow to the vital organs, but it does not reverse the allergic reaction or improve the breathing of the client. Elevating the legs and feet can be done after epinephrine, but not before or instead of it.