A 38-week primigravida client who is positive for group A Streptococcus (GAS) receives a prescription for cefazolin 2 grams IV to be infused over 30 minutes. The medication is available in "Cefazolin 2 grams/100 mL normal saline." The nurse should program the infusion pump to deliver how many mL/hour? (Enter numeric value only.)

Rationale:

A. Obtain temperature assessment prior to aspirin administration: Monitoring temperature is important to evaluate the effectiveness of antipyretics. However, it does not address the risk of fluid imbalance or cardiovascular complications, which are more urgent in Kawasaki disease.

B. Maintain meticulous oral hygiene and lubrication of lips: Oral care helps prevent discomfort from mucous membrane changes such as cracked lips and strawberry tongue. Although important for comfort, it is not the priority during the acute inflammatory phase.

C. Provide passive range of motion exercises: Passive range of motion can prevent joint stiffness due to inflammation. While beneficial, musculoskeletal interventions are secondary to monitoring for complications related to cardiovascular status and hydration.

D. Monitor fluid intake and output and daily weight: Monitoring intake, output, and weight is crucial because Kawasaki disease can cause systemic inflammation, edema, and potential cardiac complications like myocarditis or heart failure. Accurate fluid balance assessment helps prevent worsening cardiac function and guides clinical management in the acute phase.

Rationale:

A. Let the infant breastfeed: Breastfeeding stimulates oxytocin release, which can promote uterine contraction and help prevent postpartum hemorrhage. While beneficial, it is not the first action when active bleeding is observed.

B. Assess her blood pressure: Monitoring blood pressure is a priority when continuous bright red vaginal bleeding occurs after delivery. Assessing vital signs allows the nurse to determine the hemodynamic stability of the client and identify early signs of hypovolemic shock, guiding urgent interventions.

C. Massage the fundus vigorously: The fundus is already firm at the umbilicus, indicating effective uterine contraction. Vigorous massage is unnecessary and may cause discomfort or trauma without addressing the source of bleeding.

D. Apply ice pack to perineum: Ice packs are useful for perineal pain or swelling but do not control vaginal bleeding from uterine sources. This intervention does not address the priority concern of postpartum hemorrhage.