A nurse is preparing to administer estradiol cypionate 4 mg IM to a client who is experiencing ovarian failure. Available is estradiol cypionate injection 5 mg/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.)

A) Offer the medication now to prevent saturation of the perineal pad: This interpretation is incorrect because the prescription specifies that oxytocin should be administered based on the clinical condition, which is the saturation of a perineal pad within 15 minutes. Administering the medication prophylactically without signs of excessive bleeding could be unnecessary and potentially harmful.

B) Give the medication each time the client saturates the perineal pad within 15 min: This interpretation is incorrect because the prescription specifies that oxytocin should be administered only once if the client saturates a perineal pad within 15 minutes, not repeatedly with each subsequent saturation. Repeated dosing of oxytocin could be dangerous, as it can cause uterine hyperstimulation, increased bleeding, and other complications. The prescription indicates a single dose in response to a specific finding.

C) Wait 15 min to administer the medication after the client saturates a perineal pad: This interpretation is incorrect because the prescription directs that the medication be administered immediately once the client saturates a perineal pad within 15 minutes, not after waiting an additional 15 minutes. Delaying the medication could put the client at risk for excessive blood loss or hemorrhage, which is why prompt administration is indicated.

D) Administer the medication once if the client saturates the perineal pad within 15 min: The prescription specifies that oxytocin 10 units IM should be administered as a one-time dose if the client saturates a perineal pad within 15 minutes. The goal of this intervention is to address potential postpartum hemorrhage by promoting uterine contraction, which can help reduce excessive bleeding.

A) The nurse should administer terbutaline each time the client has more than four contractions in an hour: This interpretation is incorrect because the prescription is for PRN (as needed) administration based on the occurrence of more than four uterine contractions per hour, not every time the client has more than four contractions. The medication should not be administered automatically at each instance of more than four contractions, but rather when it is specifically indicated as per the prescribed instructions.

B) The nurse should begin administering terbutaline every 4 hr for 24 hr: This interpretation is not accurate because the prescription does not state that terbutaline should be given regularly every 4 hours regardless of the client's condition. Instead, it specifies that terbutaline should be administered as needed (PRN) only when the client has more than four uterine contractions per hour. Routine administration every 4 hours is not appropriate unless specified in the prescription.

C) The nurse should administer terbutaline once every 24 hr to prevent the client from having more than four contractions per hour: Administering terbutaline on a fixed schedule every 24 hours is not consistent with the prescription. The prescription specifically indicates that terbutaline is only to be administered as needed (PRN) when the client is experiencing more than four contractions per hour.

D) The nurse should wait until the client has more than four contractions in 1 hr before administering terbutaline: This interpretation aligns with the prescription. Terbutaline is to be administered only when the client has more than four uterine contractions in one hour, and this should be done on a PRN basis. The medication is intended to manage excessive uterine activity, and its administration should be based on the client's current condition (i.e., the presence of more than four contractions per hour), not preemptively or on a regular schedule.