A nurse is preparing to administer liquid mycostatin 600,000 units PO TID. Available is mycostatin 100,000 units/mL. How many m. should the

nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Choice A reason:
In the case of a client with painless, bright red vaginal bleeding at 38 weeks of gestation, the priority is to stabilize the client's condition. Initiating IV access is crucial as it allows for rapid administration of fluids or blood products to address potential hypovolemia and to prepare for the possibility of an emergency cesarean section if needed. The client's low blood pressure and elevated heart rate suggest that she may be experiencing hypovolemia, which can quickly lead to hypovolemic shock if not treated promptly.

Choice B reason:
While obtaining informed consent is important before any surgical procedure, it is not the immediate priority. The priority is to stabilize the client, and consent can be obtained concurrently with other stabilizing actions or by another member of the healthcare team.

Choice C reason:
Inserting an indwelling urinary catheter is a supportive measure that can be necessary during labor or before surgery to keep the bladder empty, reducing the risk of bladder injury during a cesarean section and monitoring urine output as an indicator of renal perfusion. However, it is not the first priority in the presence of significant vaginal bleeding.

Choice D reason:
Preparing the abdominal and perineal areas is part of the preoperative procedure for a cesarean section. This action would follow after the client has been stabilized and a decision for surgery has been made.

Choice A reason:
A negative rubella titer indicates that the client does not have immunity to the rubella virus. Immunity would be indicated by a positive titer, showing the presence of rubella IgG antibodies in the blood. Therefore, this choice is incorrect.

Choice B reason:
While the client does not have immunity, administering a rubella vaccination during pregnancy is not recommended due to the theoretical risk to the fetus. Vaccinations with live viruses, like the rubella vaccine, are generally avoided during pregnancy.

Choice C reason:
A negative rubella titer does indeed indicate that the client is not currently experiencing a rubella infection, as active infection would be indicated by the presence of rubella IgM antibodies. However, this choice does not address the client's susceptibility to future infection or the need for immunization.

Choice D reason:
The correct interpretation of a negative rubella titer in an antepartum client is that she is not immune to rubella and should receive the rubella immunization after delivery. This is to ensure immunity and prevent the possibility of contracting rubella in future pregnancies, which could be harmful to the fetus.