A nurse is preparing to administer phenobarbital 3 mg/kg/day PO in two divided doses to a client who weighs 145 lb. The amount available is phenobarbital 100 mg/tablet. How many tablets 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.)

A. "Place a thick layer of the medication on open areas." Topical corticosteroids like fluticasone should not be applied in thick layers or to open wounds, as excessive absorption can lead to systemic side effects such as adrenal suppression. A thin layer is sufficient to achieve the desired anti-inflammatory effects while minimizing adverse reactions.

B. “Rub the medication until it disappears.” Topical corticosteroids should be applied in a thin layer and gently rubbed into the skin until no visible residue remains. This ensures even absorption without excessive medication buildup, reducing the risk of local and systemic side effects, especially in infants who have a higher risk of absorption due to their thinner skin.

C. "Cover the area with an occlusive dressing." Occlusive dressings increase medication absorption, which can lead to systemic corticosteroid effects such as skin thinning, delayed wound healing, and adrenal suppression. Occlusion should only be used under medical supervision, especially in infants who are more susceptible to these effects.

D. "Apply the medication to your infant's entire arm." Fluticasone should be applied only to affected areas, not the entire limb. Applying it over a larger area than necessary increases the risk of systemic absorption and side effects. The medication should be used only as directed for targeted treatment of atopic dermatitis.

A. Baker's yeast. The hepatitis B vaccine is contraindicated in individuals with a severe allergy to baker’s yeast. This is because the vaccine is produced using Saccharomyces cerevisiae (baker’s yeast), which can trigger an allergic reaction in susceptible individuals. Symptoms of a yeast allergy may include rash, difficulty breathing, and anaphylaxis, requiring the vaccine to be withheld and an alternative plan considered.

B. Nuts. Nut allergies are not related to the hepatitis B vaccine, as it does not contain nut-derived ingredients. While nut allergies can be severe and cause anaphylaxis, they do not pose a specific risk in the administration of this vaccine. Therefore, the presence of a nut allergy alone does not require withholding the immunization.

C. Wheat. A wheat allergy is not a contraindication for the hepatitis B vaccine. Wheat allergies primarily cause reactions to gluten-containing foods or products but do not have any connection to the components used in the production of the vaccine. The vaccine can be safely administered to individuals with wheat allergies.

D. Egg yolk. While some vaccines, such as the influenza vaccine, may be derived from egg proteins, the hepatitis B vaccine is not produced using egg-based components. An allergy to egg yolk does not pose a risk for adverse reactions to this vaccine, so it should not be withheld in individuals with an egg allergy.