A nurse is preparing to administer darbepoetin 0.45 mcg/kg subcutaneous once weekly to a client who weighs 198 lb. The amount available is Darbepoetin 300 mcg/mL. How many mL should the nurse administer?
(Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Choice A reason: This choice is incorrect because sulfa allergy is not a priority assessment for the nurse to make prior to giving nifedipine. Sulfa allergy is a hypersensitivity reaction to drugs that contain sulfonamide, such as antibiotics, diuretics, or antidiabetic agents. Sulfa allergy can cause symptoms such as rash, itching, fever, or anaphylaxis. Nifedipine does not contain sulfonamide and does not cross-react with sulfa drugs. The nurse should ask the client about any drug allergies and document them, but sulfa allergy is not relevant to nifedipine.

Choice B reason: This choice is incorrect because aPTT is not a priority assessment for the nurse to make prior to giving nifedipine. aPTT stands for activated partial thromboplastin time, which is a measure of how long it takes the blood to clot. It is used to monitor the effect of anticoagulant drugs, such as heparin, that prevent blood clots. Nifedipine does not affect the blood clotting time and does not interact with anticoagulant drugs. The nurse should check the aPTT only if the client is taking anticoagulant drugs and has signs of bleeding or clotting.

Choice C reason: This choice is incorrect because hemoglobin is not a priority assessment for the nurse to make prior to giving nifedipine. Hemoglobin is a protein in the red blood cells that carries oxygen to the tissues and organs of the body. Hemoglobin levels can be affected by conditions such as anemia, dehydration, or blood loss. Nifedipine does not affect the hemoglobin levels or the oxygen delivery. The nurse should monitor the hemoglobin levels and the signs of anemia, such as fatigue, pallor, or shortness of breath, but they are not related to nifedipine.

Choice D reason: This choice is correct because blood pressure is the priority assessment for the nurse to make prior to giving nifedipine. Nifedipine is a calcium channel blocker that lowers blood pressure and relaxes the blood vessels. It is used to treat conditions such as hypertension, angina, and Raynaud's phenomenon. However, nifedipine can cause side effects such as hypotension (low blood pressure), dizziness, headache, flushing, and edema (swelling). The nurse should check the client's blood pressure before giving nifedipine and withhold the dose if the blood pressure is too low. The nurse should also monitor the client's blood pressure and the signs of hypotension, such as fainting, weakness, or chest pain.

To calculate the amount of voriconazole to be administered, we can follow these steps:

Convert the client's weight from pounds to kilograms.

Calculate the total amount of voriconazole needed based on the client's weight.

Determine the volume of the medication to be administered based on the concentration of the available solution.

Let's proceed with the calculations:

Converting the client's weight from pounds to kilograms:

Client's weight = 127 lb

1 lb ≈ 0.453592 kg

Client's weight ≈ 127 lb 0.453592 kg/lb ≈ 57.61 kg

Calculating the total amount of voriconazole needed:

Voriconazole dose = 6 mg/kg 57.61 kg ≈ 345.66 mg

Determining the volume of the medication to be administered:

Available voriconazole concentration = 5 mg/mL

Volume to be administered = 345.66 mg / 5 mg/mL ≈ 69.132 mL

Rounding to the nearest whole number, the nurse should administer 69 mL of voriconazole.