A client is prescribed to receive 375 mL of PRBCs to infuse over 3.5 hours on an infusion pump.

What would the nurse set the infusion pump (mL/hr) to run? (Do not use a leading zero, Round to a whole number)

Choice A rationale

Post-kidney transplant, immunosuppressive medications are crucial to prevent rejection, which also compromises the immune system. Engaging in contact sports significantly increases the risk of direct trauma to the transplanted kidney, potentially causing injury or rupture, which could necessitate re-transplantation or lead to graft loss.

Choice E rationale

Grapefruit contains furanocoumarins, compounds that inhibit the cytochrome P450 3A4 (CYP3A4) enzyme system in the liver and intestines. Many immunosuppressants, like calcineurin inhibitors (e.g., cyclosporine, tacrolimus), are metabolized by CYP3A4. Inhibition of this enzyme can lead to increased drug concentrations and elevated risk of toxicity.

Choice F rationale

Fluid restriction post-kidney transplant may be necessary, particularly in the immediate postoperative period or if the patient experiences fluid overload or delayed graft function. Excessive fluid intake could contribute to hypertension or pulmonary edema, complicating recovery and potentially stressing the newly transplanted kidney.

Choice A rationale

The statement "I can change who I designate as my health care proxy at any time" indicates a correct understanding. A health care proxy designation is a revocable document, meaning the individual can modify or revoke their chosen proxy at any point, provided they have the decisional capacity to do so, reflecting their evolving wishes.

Choice B rationale

The statement "The health care proxy does not go into effect until I am incapable of making decisions" indicates a correct understanding. A health care proxy's authority is activated only when the principal is deemed medically incapacitated and unable to communicate their own healthcare decisions, preserving patient autonomy while capable.

Choice C rationale

The statement "If I become incapacitated, end-of-life choices will be made by my proxy" indicates a correct understanding. The designated health care proxy is legally empowered to make medical decisions, including end-of-life choices, on behalf of the incapacitated individual, aligning with the patient's previously expressed wishes or acting in their best interest.

Choice D rationale

The statement "I have to choose a family member as my health care proxy" indicates a need for clarification. While many individuals choose a family member, the law does not restrict the choice of a health care proxy to family members only. A person can designate any trusted adult, such as a friend, as their proxy, as long as they are competent and willing to serve. .