The healthcare provider prescribes dalteparin 200 units/kg SUBQ once a day for a client who weighs 154 lb. The medication is available in 25,000 units/mL vial. How many mL should the nurse administer? (Enter numerical value only. If rounding is required, round to the nearest tenth.)

A. Ensure supplemental oxygen and respiratory medications are available at all times: Access to medications and oxygen is essential for managing acute symptoms, but this measure focuses on treatment, not prevention.

B. Use nasal or cough tissues followed by handwashing at all times: Proper hygiene can limit infection spread, but it does not offer strong enough protection alone. It is supportive but not the most comprehensive or impactful preventive measure for respiratory clients.

C. Avoid large crowded areas during the colder months of the year: Crowd avoidance can reduce exposure to respiratory infections, but it is a general guideline. Immunizations offer more reliable protection against the common causes of exacerbations in clients with chronic respiratory diseases.

D. Get annual flu and Pneumococcal vaccine polyvalent (PPSV23) vaccines: Vaccinations are the most important preventive step for clients with chronic respiratory conditions. These clients are at high risk for complications from influenza and pneumococcal infections, and immunization significantly lowers the incidence and severity of these diseases.

Rationale:

• Respirations: After administering morphine, it is crucial to monitor the client's respirations because opioids can cause respiratory depression, which may be more pronounced in elderly patients or those who are in pain and immobile.
• Deep breathing techniques: The nurse should encourage deep breathing techniques. This helps improve lung expansion and reduces the risk of respiratory complications such as pneumonia and atelectasis, especially in a client with decreased mobility due to pain and injury.

Rationale for Incorrect Options:

• Heart rate: While heart rate monitoring is important, it is not the primary concern immediately after morphine administration. The client's respiratory status takes precedence, especially considering the risk of opioid-induced respiratory depression.
• Blood pressure: While blood pressure monitoring is essential, morphine administration primarily affects the respiratory system, not the circulatory system. The nurse should prioritize respiratory monitoring over blood pressure unless the patient exhibits signs of hypotension.
• Range of motion exercises: Range of motion exercises are important for mobility and rehabilitation, but they are not a priority immediately following the trauma and morphine administration. The client should be assessed and stabilized before beginning exercises.
• Joint protection techniques: Joint protection techniques are beneficial in long-term rehabilitation, but in the acute phase, the priority is to manage the fracture, pain, and prevent further complications.