A nurse is preparing to administer metoprolol 5 mg IV bolus to a client for heart rate control. Available is metoprolol injection 1 mg/mL. How many mL should the nurse administerperdose?

A. "I have a difficult time falling asleep at night":

Difficulty falling asleep at night is not typically a direct symptom of iron-deficiency anemia. While anemia can lead to fatigue and general tiredness, which might affect sleep quality, insomnia or difficulty falling asleep may have various causes unrelated to anemia. These causes can include stress, anxiety, poor sleep hygiene, or other underlying medical conditions.

B. "I have an increase in my appetite":

This choice is not directly related to iron-deficiency anemia. While some individuals with anemia may experience changes in appetite, such as increased hunger, this symptom is not specific to iron-deficiency anemia alone. An increase in appetite can have various causes, including hormonal changes, dietary changes, medications, or psychological factors.

C. "I have difficulty breathing when walking 30 feet":

This choice is the correct answer. Difficulty breathing, especially during exertion like walking, is a hallmark symptom of iron-deficiency anemia. Anemia reduces the oxygen-carrying capacity of the blood, leading to inadequate oxygen delivery to tissues, which can result in shortness of breath, fatigue, and difficulty with physical activities.

D. "I feel hot all of the time":

Feeling hot all the time is not a specific symptom of iron-deficiency anemia. While anemia can cause symptoms such as fatigue, weakness, pale skin, and shortness of breath, it does not directly lead to a constant feeling of heat or warmth throughout the body. Feeling hot or experiencing excessive sweating could be due to other factors such as hormonal changes, fever, hyperthyroidism, or environmental conditions.

A. Folic acid deficiency anemia:

Folic acid deficiency anemia is characterized by a lack of folate (vitamin B9), which is essential for red blood cell production. Symptoms can include weakness and fatigue, similar to iron-deficiency anemia. However, folic acid deficiency anemia typically does not cause heavy menstrual periods. Laboratory findings may show a low level of folate in the blood, but the hemoglobin level of 8 g/dL and hematocrit level of 28 g/dL alone do not specifically indicate folic acid deficiency anemia without considering other factors like mean corpuscular volume (MCV) and red blood cell indices.

B. Pernicious anemia:

Pernicious anemia is caused by a lack of intrinsic factor, a substance needed for the absorption of vitamin B12. It can lead to symptoms such as weakness and fatigue. However, heavy menstrual periods are not a characteristic feature of pernicious anemia. Laboratory findings may show a low hemoglobin and hematocrit level, but again, other factors such as MCV and vitamin B12 levels would be needed to confirm this type of anemia.

C. Iron-deficiency anemia:

Iron-deficiency anemia occurs due to insufficient iron stores in the body, leading to decreased hemoglobin and hematocrit levels. This type of anemia is commonly associated with symptoms like weakness, fatigue, and heavy menstrual periods in women due to blood loss. The client's hemoglobin level of 8 g/dL and hematocrit level of 28 g/dL are consistent with iron-deficiency anemia, making this the most likely choice based on the information provided.

D. Sickle cell anemia:

Sickle cell anemia is a genetic disorder characterized by abnormal hemoglobin that causes red blood cells to become sickle-shaped and less flexible. It typically presents with symptoms such as anemia, pain crises, and organ damage. However, the client's symptoms of weakness, fatigue, and heavy menstrual periods are not specific to sickle cell anemia. Additionally, sickle cell anemia would have different laboratory findings, including a different pattern on peripheral blood smear and hemoglobin electrophoresis.