A nurse is preparing to administer hydroxyzine 60 mg PO every 8 hr to a client who has generalized anxiety disorder. Available is hydroxyzine 10 mg/5 mL solution. How many mL should the nurse administer for the total daily dose?
(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A. Discuss the provider's goals for the client's care:
Discussing the provider's goals is essential, but it may not directly address the client's concerns about medication adherence. While these goals are important for the overall care plan, it's crucial to first engage in a conversation with the client about their specific issues and challenges related to taking the prescribed medication. The client's perspective and concerns should be a priority.

B. Ask the client if the medication is causing adverse effects:
This is the recommended choice. Inquiring about adverse effects is important to understand the client's experience with the medication. Some clients may discontinue their medication due to intolerable side effects. By addressing this concern, the nurse can provide education, seek potential solutions, and collaborate with the healthcare team to adjust the medication or dosage. Open communication helps to identify and mitigate barriers to medication adherence.

C. Tell the client they will be admitted to an inpatient care facility if they do not take the medication:
This choice involves a coercive and threatening approach. It's not an ethical or therapeutic method to promote medication adherence. Threatening involuntary hospitalization can create fear and mistrust, potentially leading to further non-compliance and damaging the therapeutic relationship. It should be avoided.

D. Request the provider prescribe a second antipsychotic medication to the client:
This option is not appropriate at this stage. Adding another medication without addressing the underlying issue of non-adherence and without assessing the client's response to the current medication is not advisable. It can complicate the medication regimen, potentially worsen side effects, and doesn't address the primary concern, which is the client's non-adherence to their current medication. It's important to understand the reasons for non-adherence before considering additional medications.

To find out how many mL the nurse should administer for the total daily dose, we need to calculate the total daily dose and then convert it to mL using the available concentration.

The client is prescribed hydroxyzine 60 mg PO every 8 hours. To find the total daily dose, we can first calculate the dose per day and then convert it to mL.

Dose per day = Dose per dose interval x Number of doses per day

Dose per day = 60 mg x 3 (every 8 hours)

Dose per day = 180 mg per day

Now, we need to convert this dose to mL using the available concentration:

Concentration: 10 mg/5 mL

To find out how many mL for 180 mg, we can set up a proportion:

(10 mg / 5 mL) = (180 mg / x mL)

Cross-multiply:

10 mg * x mL = 5 mL * 180 mg

Now, solve for x (the number of mL):

x mL = (5 mL * 180 mg) / 10 mg

x mL = 900 mL / 10 mg

x mL = 90 mL

So, the nurse should administer 90 mL for the total daily dose.