The physician orders an injection of dexamethasone (Decadron) 6mg IM for a patient.

The available stock is dexamethasone 4mg/1ml in a 5ml multidose vial.

How many mLs of this medication will the nurse prepare?

Choice A rationale:

Double vision is not a common side effect of quinolones. Quinolones are a type of antibiotic that are used to kill or inhibit the growth of bacteria. While they can have side effects, double vision is not typically one of them.

Choice B rationale:

Tendonitis and tendon rupture are known adverse effects of quinolones. These antibiotics can very rarely cause long-lasting, disabling, and potentially irreversible side effects, sometimes affecting multiple systems, organ classes, and senses. One of these side effects is damage to the tendons, which can manifest as tendonitis (inflammation of the tendon) or even tendon rupture. This is particularly a concern for people older than 60 years and for those with renal impairment or solid-organ transplants because they are at a higher risk of tendon injury.

Choice C rationale:

Neuralgia, or nerve pain, is not a common side effect of quinolones. While these antibiotics can affect the nervous system and cause side effects such as peripheral neuropathy and central nervous system effects, neuralgia is not typically reported.

Choice D rationale:

Hypotension, or low blood pressure, is not typically associated with the use of quinolones. These antibiotics can have various side effects, but a significant drop in blood pressure is not commonly reported.

Choice A rationale:

The client stating, “I haven’t had anything to eat or drink since last night” is not a cause for concern. This is because patients are often advised to fast before undergoing certain medical procedures or tests, including an intravenous pyelogram (IVP).

Fasting helps to ensure that the test results are accurate and not influenced by recent food or drink consumption.

Choice B rationale:

The client expressing that “The last time I voided it was painful” could be related to their recurrent kidney stones. Kidney stones can cause discomfort or pain during urination. However, this statement does not necessarily require additional data collection in the context of an IVP. The pain could be a symptom of the kidney stones rather than a contraindication for the IVP1.

Choice C rationale:

The statement “I took my metformin before breakfast” is of concern. Metformin is a medication used to treat type 2 diabetes. It is important for the nurse to collect additional data about this statement because metformin can potentially interact with the iodine-based contrast dye used in an IVP. This interaction can increase the risk of lactic acidosis, a serious and potentially lifethreatening condition. Therefore, patients are often advised to stop taking metformin before and for a couple of days after having an IVP12. Choice D rationale:

The client mentioning, “I took a laxative yesterday” is not necessarily alarming. Laxatives are often used before an IVP to clear the bowels, which helps to ensure clear images during the procedure. Therefore, this statement does not require additional data collection in the context of an IVP1.