A nurse is preparing to administer tobramycin 3 mg/kg/day IM in three divided doses to a client who weighs 85 kg. The amount available is Tobramycin 40 mg/mL. How many mL should the nurse administer per dose?
(Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Choice A reason: This is incorrect because a dry cough is not a common or serious side effect of hydralazine. A dry cough is more likely to occur with angiotensin-converting enzyme (ACE) inhibitors, which are another class of antihypertensive drugs.

Choice B reason: This is incorrect because hydralazine does not cause a low heart rate. In fact, hydralazine can cause a reflex increase in heart rate as a result of lowering the blood pressure. This is why hydralazine is often given with a beta-blocker, which can slow down the heart rate.

Choice C reason: This is incorrect because hydralazine does not interact with birth control. However, the nurse should advise the client to use effective contraception while taking hydralazine, as this medication can cause fetal harm if used during pregnancy.

Choice D reason: This is correct because hydralazine can cause orthostatic hypotension, which is a sudden drop in blood pressure when changing positions. This can lead to dizziness, fainting, and falls. The nurse should instruct the client to avoid getting up too quickly and to ask for assistance if needed.

Choice A reason: Age is a non-modifiable risk factor for hypertension because the risk of high blood pressure increases as we get older. This is due to changes in the heart and blood vessels, such as loss of elasticity and stiffening of the arteries, that affect the blood flow and pressure. ¹

Choice B reason: Genetics is a non-modifiable risk factor for hypertension because some people inherit genes that make them more likely to develop high blood pressure. For example, people of African and Black Caribbean descent have a higher risk of hypertension due to genetic variations that affect salt sensitivity and blood vessel function. ²

Choice C reason: Smoking is a modifiable risk factor for hypertension because it can be changed or avoided by quitting tobacco use. Smoking damages the blood vessels and increases the risk of atherosclerosis, which is the buildup of plaque in the arteries that narrows them and raises blood pressure. Smoking also lowers the level of good cholesterol (HDL) and raises the level of bad cholesterol (LDL) and triglycerides, which are fats in the blood that contribute to plaque formation. ³

Choice D reason: Obesity is a modifiable risk factor for hypertension because it can be changed or prevented by losing weight or maintaining a healthy weight. Obesity increases the risk of high blood pressure by putting extra strain on the heart and blood vessels, as well as by causing hormonal and metabolic changes that affect blood pressure regulation. Obesity is also associated with other conditions that can raise blood pressure, such as diabetes, sleep apnea, and kidney disease. ⁴

Choice E reason: Sedentary lifestyle is a modifiable risk factor for hypertension because it can be changed or improved by increasing physical activity. Sedentary lifestyle increases the risk of high blood pressure by reducing the ability of the blood vessels to dilate and contract, as well as by increasing the risk of obesity, diabetes, and high cholesterol. Physical activity helps to lower blood pressure by improving blood flow, strengthening the heart muscle, and lowering body weight and stress levels. .