A nurse is preparing to administer clindamycin 300 mg by intermittent IV bolus over 30 min to a client who has a staphylococcal infection.
Available is clindamycin 900 mg in 50 mL. How many mL/hr should the nurse set the IV pump to? (Round to the nearest whole number, use a leading zero if it applies, do not use a trailing zero)

Choice A rationale:
Hydroxychloroquine can cause a rare but serious side effect called bone marrow suppression. This is a decrease in the production of blood cells in the bone marrow.
White blood cells (WBCs) are a key component of the immune system, and a decrease in WBCs can make a patient more susceptible to infections.
Therefore, it's crucial for nurses to monitor the patient's WBC count to detect any potential bone marrow suppression early and take necessary actions to prevent or manage infections.
Choice B rationale:
An increased blood cell count is not a typical side effect of hydroxychloroquine.
Some conditions, like polycythemia vera, can cause an increase in blood cell count, but they are not related to hydroxychloroquine use.

Choice C rationale:
While hydroxychloroquine can sometimes cause a decrease in platelet count, it's less common than bone marrow suppression affecting WBCs.
However, it's still essential for nurses to monitor platelet counts as well, as a significantly low platelet count can impair blood clotting and increase the risk of bleeding.
Choice D rationale:
Hydroxychloroquine does not typically affect red blood cell (RBC) counts.
Conditions that affect RBC counts, such as anemia, are not directly related to hydroxychloroquine use.

Choice A is incorrect: Caffeine can worsen sleep disturbances, a common symptom of fibromyalgia.
Choice B is incorrect: While duloxetine is a medication used to manage fibromyalgia symptoms, taking it at a specific time for increased energy is not directly related to understanding the disease itself.
Choice C is incorrect: Fibromyalgia is a chronic condition with no cure. Chemotherapy is not indicated for its treatment.

Choice D is correct: Low-impact aerobics like walking, swimming, or yoga are recommended non-pharmacological interventions for fibromyalgia. They can improve cardiovascular health, flexibility, and pain management.
Additional notes:
Other non-pharmacological management strategies for fibromyalgia include stress management techniques, cognitive behavioral therapy, and adequate sleep hygiene.
Early and comprehensive management of fibromyalgia can significantly improve quality of life.