A nurse is preparing to administer labetalol 40 mg IV to a client. Available is labetalol 5 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Rationale:

A. "Let's talk about what you already know about immunizing your baby.": This response uses open-ended, nonjudgmental communication to explore the parents' beliefs and knowledge. It encourages dialogue, builds trust, and opens the door for education about vaccine safety and benefits.

B. "Your baby's immunizations should be up to date before they are able to travel with you by airplane.": This statement may feel coercive or irrelevant if the parents are not currently planning to travel. It does not address their current concerns or promote open discussion.

C. "You don't have to immunize your baby against diseases that are no longer common.": Diseases like measles and pertussis can still occur and spread quickly in under-immunized communities. Vaccination remains essential to maintain herd immunity and prevent outbreaks.

D. "The provider can give you a referral for your baby to see an infectious disease provider.": Referring to a specialist at this stage may come across as dismissive or escalate the situation unnecessarily. Primary care providers and nurses can often address vaccine concerns effectively through discussion and education.

Rationale:

• Prolonged rupture of membranes: Membranes ruptured for over 24 hours (28 hr), increasing the risk for ascending bacterial infections such as endometritis or chorioamnionitis.
• Prenatal anemia: Anemia reduces immune function and tissue oxygenation, making the client more susceptible to postpartum infections, including uterine and systemic infections.
• Polyhydramnios: Excessive amniotic fluid causes uterine overdistension, which weakens uterine contractility and increases the risk of atony and postpartum hemorrhage.
• High parity: Repeated stretching of the uterus in grand multiparity reduces muscle tone, making the uterus less responsive to postpartum contraction and more prone to atony.