A client in active labor receives a prescription for oxytocin 6 milliunits/minute intravenously (IV). The IV bag contains oxytocin 10 units in lactated Ringer’s 1,000 mL. How many mL/hour should the nurse program the infusion pump to deliver? (Enter numerical value only.)

Choice A rationale

Glucose water may be soothing due to the sweet taste, but it does not address the immediate need to protect the circumcision site from infection and aid in healing.

Choice B rationale

Liquid acetaminophen provides pain relief, but it does not address the immediate need to protect the circumcision site. Pain management alone is not sufficient for postoperative care.

Choice C rationale

Applying petrolatum gauze dressings on the site prevents the wound from sticking to the diaper, reduces irritation, and protects against infection, promoting healing. This is a priority intervention post-circumcision.

Choice D rationale

While keeping the infant warm is important for comfort and stability, it does not directly address the need to care for the circumcision site to prevent complications and promote healing.

Rationale for correct condition: Hypoglycemia in neonates can present with jitteriness, low body temperature, and poor feeding. Normal blood glucose levels for neonates range from 40-60 mg/dL. The Ballard maturity rating of 37 weeks indicates that the neonate may have an immature glucose metabolism. Early recognition and treatment are crucial to prevent complications.

Rationale for correct actions:

• Giving dextrose solution orally quickly increases blood glucose levels. This provides an immediate source of glucose to the neonate.
• Performing a heel stick for blood glucose testing allows for accurate monitoring of glucose levels. Continuous assessment ensures timely intervention.

Rationale for correct parameters:

• Blood glucose levels: Monitoring ensures that the neonate maintains normal glucose levels (40-60 mg/dL). This helps prevent hypoglycemia-related complications.
• Temperature: Neonates with hypoglycemia often have low body temperature. Monitoring temperature aids in detecting and addressing hypothermia.

Rationale for incorrect conditions:

• Altered respiratory function: The neonate has normal respiratory rate and heart rate.
• Thermoregulation: Although temperature is low, the jitteriness is more indicative of hypoglycemia.
• Sepsis: No signs of infection such as fever or elevated white blood cell count are present.

Rationale for incorrect actions:

• Provide manual breaths with a bag-valve mask: Not necessary as the neonate's respiratory rate is normal.
• Administer intravenous antibiotics: No signs of infection or sepsis.
• Place the neonate under a radiant warmer: This addresses temperature but not blood glucose levels.

Rationale for incorrect parameters:

• Respiratory rate: Normal, does not indicate hypoglycemia.
• Oxygen saturation: No signs of respiratory distress.
• Bilirubin levels: Not relevant to the current symptoms.