The prescription reads for guaifenesin 400 mg PO every 4 hours as needed for congestion. Using the label below, how many mL will the nurse administer to the client? Enter a numeric value only. Answer to the nearest whole mL.

A) The stomach acid has a lower pH level which results in increased absorption: While it is true that neonates have a lower gastric pH, which could affect the absorption of certain medications, this factor does not directly increase the risk for drug toxicity. Lower pH may increase absorption for some drugs, but it is not as critical in neonates as the immaturity of other organs, such as the liver and kidneys, which are responsible for drug metabolism and excretion.

B) The glomerular filtration rate (GFR) is increased causing rapid excretion: In neonates, the glomerular filtration rate (GFR) is actually decreased, not increased. This leads to slower excretion of medications, which can increase the risk for drug toxicity, especially for drugs that rely on renal elimination. This decreased renal function can result in accumulation of the drug in the bloodstream, potentially leading to toxicity.

C) The liver enzyme system responsible for drug metabolism is not fully developed: The liver enzyme system in neonates is immature, which significantly impacts the metabolism of drugs. Enzymatic activity is critical for breaking down medications to their active or inactive forms. Due to the underdeveloped liver function, drugs may not be metabolized properly, leading to a longer half-life and an increased risk for drug toxicity. This is a key factor in the increased risk of toxicity in neonatal clients.

D) The albumin levels are elevated due to rapid growth and protein binding is enhanced: Neonates typically have lower albumin levels, not elevated levels. Albumin is crucial for binding medications, and lower levels in neonates can result in more free (unbound) drug circulating in the bloodstream, which can increase the risk of drug toxicity. Elevated albumin would theoretically reduce this risk, but this is not typically the case in neonates.

A) Use perfumes and air fresheners: Using perfumes and air fresheners may actually worsen nausea for some clients, as strong scents can trigger or exacerbate feelings of nausea, particularly in individuals undergoing chemotherapy. It is generally advisable to avoid strong odors in the environment to prevent triggering nausea.

B) Eat foods that are high in fibre: While a balanced diet is important, high-fibre foods may not be helpful in managing nausea and vomiting associated with chemotherapy. In fact, high-fibre foods can sometimes contribute to gastrointestinal discomfort, bloating, or constipation, which may worsen nausea in certain individuals. Therefore, fibre-rich foods are not the best option for reducing nausea and vomiting in this scenario.

C) Drink clear and carbonated beverages: Drinking clear liquids, such as water, ginger ale, or clear broths, can help reduce nausea by keeping the client hydrated and soothing the stomach. Carbonated beverages, such as ginger ale, are often recommended because the bubbles can help alleviate nausea and provide some relief. This is a well-established strategy for managing chemotherapy-related nausea and vomiting.

D) Walk frequently throughout the day: While physical activity is generally beneficial for overall health, walking frequently may not directly address nausea and vomiting caused by chemotherapy. In some cases, walking might even worsen nausea if the client is feeling weak or dizzy. Resting and staying hydrated may be more beneficial in the management of nausea associated with chemotherapy.