A nurse is preparing to administer hydromorphone 2.5 mg. The available amount is 5 mg/5 mL elixir.

How many mL should the nurse administer?

Choice A rationale:

Rifampin is an antibiotic used to treat or prevent tuberculosis (TB). However, the treatment with this medication typically lasts longer than one month. In fact, TB treatment usually involves taking several drugs for a long time.

Choice B rationale:

While it’s important to take some medications with meals to increase absorption or decrease stomach upset, rifampin should be taken at least 1 hour before or 2 hours after a meal. This helps to ensure optimal absorption of the medication.

Choice C rationale:

Insomnia is not typically listed as a common side effect of rifampin. The medication can cause a number of side effects, but these more commonly include things like upset stomach, loss of appetite, nausea, vomiting, diarrhea, and changes in behavior.

Choice D rationale:

One of the known side effects of rifampin is that it can cause a red-orange discoloration of body fluids, including urine, sweat, saliva, and tears. This can be alarming to patients if they are not forewarned, so it’s important for the nurse to provide this information during discharge instructions.

The correct answer is Choice D.

Let’s go through the calculations step by step:

Step 1: Convert all the quantities to milliliters (mL), as the nurse needs to record the intake in mL. We know that 1 oz is approximately 29.5735 mL.

4 oz of juice = 4 × 29.5735 mL = 118.294 mL

6 oz of tea = 6 × 29.5735 mL = 177.861 mL 8 oz of broth = 8 × 29.5735 mL = 236.628 mL Step 2: Add all the quantities together:

118.294 mL (juice) + 177.861 mL (tea) + 100 mL (soda) + 150 mL (IV bolus) + 236.628 mL (broth) = 783.783 mL Step 3: Round off the total intake to the nearest whole number as required, which gives us 784 mL.

Therefore, the nurse should record 784 mL on the patient’s chart. However, this option is not available in the choices given. The closest option to this calculated value is 800 mL (Choice D).

Now, let’s discuss the rationales for each choice:

Choice A rationale:

500 mL would be an underestimate of the patient’s fluid intake. It does not account for all the fluids the patient consumed.

Choice B rationale:

600 mL, similar to Choice A, is an underestimate. It does not accurately represent the total volume of fluids the patient consumed. Choice C rationale:

700 mL is closer to the calculated intake but is still an underestimate. It does not fully account for all the fluids the patient consumed.

Choice D rationale:

800 mL is the closest option to the calculated intake of 784 mL. Although it’s slightly over the actual intake, it’s the best choice among the given options.