A client is ordered 450 ml of Normal Saline Solution over 3 hours. The drop factor on the IV tubing is 15 drops per ml. At what rate should the nurse regulate the IV?

Answer and Explanation

The Correct Answer is ["37.5"]

Drip rate (drops per minute) = (Volume to be infused (mL) x Drop factor) / Time (minutes)

3 hours = 3 * 60 = 180 minutes
Drip rate = (450 mL x 15 drops/mL) / 180 minutes Drip rate = 6750 / 180
Drip rate = 37.5 drops per minute
Therefore, the nurse should regulate the IV at a rate of 37.5 drops per minute.

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Correct Answer is A

Explanation

A. The loss of a pulse and the cool, dusky appearance of the foot indicate potential complications such as thrombus formation or arterial occlusion, which require prompt medical evaluation and intervention. Notifying the physician ensures that appropriate diagnostic and therapeutic measures can be taken quickly.
B. While keeping the client warm is important, simply covering the limb does not address the underlying issue of compromised circulation. This action could potentially delay necessary interventions that address the lack of blood flow.
C. Although repositioning the limb might help with circulation, it is not sufficient given the critical nature of the symptoms. It is essential to first inform the physician to get guidance on further evaluation or interventions. Repositioning could also delay timely intervention needed to prevent tissue damage.
D. Elevating the limb might worsen blood flow in a case of compromised circulation. In cases of suspected arterial occlusion, keeping the limb at heart level or below may be more appropriate to promote blood flow. Elevating it could delay necessary treatment.

A. makes the blood less thick and easier to flow." B. does not thin the blood: it prevents new clots from forming." C. decreases the number of platelets so the blood clots more slowly." D. dissolves the clot and decreases the formation of platelets."

Correct Answer is B

Explanation

A. Heparin does not actually "thin" the blood in the sense of reducing viscosity. Instead, it works by inhibiting certain factors in the coagulation cascade, preventing clot formation. Thus, this response does not accurately describe how heparin functions.

B. Heparin works by activating antithrombin III, which inhibits thrombin and factor Xa, thereby preventing the formation of new clots. It does not dissolve existing clots but helps to prevent the enlargement of existing ones and the formation of new clots.
C. Heparin does not decrease the number of platelets; rather, it interferes with the clotting process by inhibiting specific clotting factors. Platelets may still be present, but their ability to form clots is inhibited by the action of heparin.
D. Heparin does not dissolve existing clots; that function is typically performed by thrombolytic agents. Heparin primarily prevents new clot formation and the extension of existing clots. Additionally, it does not decrease platelet formation.

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A client is ordered 450 ml of Normal Saline Solution over 3 hours. The drop factor on the IV tubing is 15 drops per ml. At what rate should the nurse regulate the IV?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Explanation

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