A client is admitted for acute renal failure and the nurse is monitoring their response to medications. Which pharmacokinetic principle does the nurse understand will be affected in this patient?

To find the rate in mL/hr, we need to convert the time from minutes to hours and then divide the volume by the time. Here are the steps:

1. Convert 30 minutes to hours:

30 minutes/ (60 minutes/hour)= 0.5 hours

2. Calculate the rate in mL/hr:

250 mL/ 0.5 hours = 500 mL

So, the nurse will set the pump to deliver the fluid at a rate of 500 mL/hr.

Choice A reason: This statement is false. The nurse does not need to understand that absorption will be affected in this patient, as absorption is the process of moving the drug from the site of administration into the bloodstream. Absorption is mainly influenced by the route of administration, the drug formulation, and the blood flow to the site of administration. Acute renal failure does not have a significant impact on absorption.

Choice B reason: This statement is false. The nurse does not need to understand that distribution will be affected in this patient, as distribution is the process of moving the drug from the bloodstream to the tissues and organs. Distribution is mainly influenced by the blood flow, the plasma protein binding, and the tissue affinity of the drug. Acute renal failure does not have a significant impact on distribution.

Choice C reason: This statement is false. The nurse does not need to understand that metabolism will be affected in this patient, as metabolism is the process of transforming the drug into more or less active forms by the enzymes in the liver or other organs. Metabolism is mainly influenced by the genetic factors, the liver function, and the drug interactions. Acute renal failure does not have a significant impact on metabolism.

Choice D reason: This statement is true. The nurse should understand that excretion will be affected in this patient, as excretion is the process of eliminating the drug and its metabolites from the body by the kidneys or other organs. Excretion is mainly influenced by the kidney function, the urine pH, and the drug characteristics. Acute renal failure can impair the kidney function and reduce the excretion of the drug and its metabolites. This can cause the drug to accumulate in the body and increase the risk of toxicity or adverse effects.