A 72 kg client with 60% severe thermal burns has crystalloid fluid replacement ordered using the American Burn Association (ABA) formula. The nurse will initially set the IV pump at ________ mL/hr for the first 8 hours.

A. The drug should be discontinued immediately after blood pressure increases: Stopping norepinephrine abruptly can cause a sudden drop in blood pressure. Vasoactive drugs must be adjusted gradually to maintain stable perfusion as the client responds. Sudden withdrawal places the client at risk for rapid hemodynamic deterioration.

B. The drug dose should be tapered down once vital signs improve: Vasoactive drugs like norepinephrine require gradual titration based on the client’s hemodynamic response to avoid abrupt shifts in perfusion. As blood pressure and cardiac stability improve, doses are slowly reduced while monitoring for recurrent hypotension.

C. The client should have arterial blood gases drawn every 10 minutes during treatment: Frequent ABGs are unnecessary and impractical unless the client is experiencing severe respiratory instability. Hemodynamic monitoring, vital signs, and urine output provide more precise ongoing indicators of perfusion during vasoactive therapy.

D. The infusion rate should be titrated according to client's subjective sensation of adequate perfusion: Clients in shock cannot reliably assess their own perfusion status due to impaired cognition, altered mental status, or stress. Vasoactive medications must be titrated based on objective data such as MAP, blood pressure, and urine output.

A. Aspirate from the catheter using a 60 ml syringe: Aspiration can introduce infection or damage the catheter if done routinely. It is not the first-line action for slow drainage during peritoneal dialysis. Safer interventions should be attempted first.

B. Flush the catheter with 50 mL of additional dialysate: Flushing may force fluid and increase intra-abdominal pressure, potentially causing discomfort or complications. It is not recommended as an initial step to improve drainage.

C. Advance the catheter 2 to 4 cm further into the peritoneal cavity: Manipulating the catheter manually can increase the risk of trauma or infection. Catheter position is generally fixed, and adjustments should be made only under provider guidance.

D. Reposition the client to facilitate drainage: Changing the client’s position, such as turning from side to side or elevating the head of the bed, often helps the dialysate flow freely. This is a safe and effective first action to relieve slow drainage and prevent complications like fluid retention or abdominal distention.