A client is to be started on a heparin intravenous infusion at 2,000 units per hour. On hand is an IV bag labeled 25,000 units/ 250 mL. At what rate (mL/hour) will the nurse set the pump? (Answer to the nearest whole number)

A) Cerebral Vascular Accident (CVA): While a history of a CVA (stroke) is important to consider when prescribing medications, ondansetron is not contraindicated for clients with a history of CVA. The nurse would need to assess the client’s overall neurological status and risk factors but this condition is not an immediate concern for ondansetron use.

B) Depression: Ondansetron is not typically contraindicated in patients with depression. However, the nurse should be mindful of the potential for interactions with other medications the client may be taking for depression, but there is no direct contraindication between ondansetron and depression itself.

C) Glaucoma: This is the most concerning finding. Ondansetron can increase the risk of complications in clients with glaucoma, particularly narrow-angle glaucoma. Ondansetron has some serotonin receptor-blocking properties that can cause dilation of the pupil, which could increase intraocular pressure in clients with glaucoma. Therefore, this condition would require careful monitoring, and the nurse would need to consult with the healthcare provider before administering ondansetron to a client with glaucoma.

D) Congestive Heart Failure (CHF): While patients with CHF need to be monitored for fluid balance, ondansetron is not contraindicated in clients with CHF. The primary concern in these patients would be potential fluid retention or electrolyte imbalances, but this is generally not a direct concern for the administration of ondansetron itself.

A. "Take this medication with a small sip of water or on an empty stomach":
This response is not ideal for calcium carbonate. Calcium carbonate is typically taken with food to help increase its absorption and to reduce the risk of gastrointestinal discomfort, such as constipation or bloating. Taking it on an empty stomach could cause irritation and is not the standard guideline for this medication.

B. "This medication should be taken two hours before other medications":
This is the most appropriate response. Calcium carbonate can interfere with the absorption of other medications, particularly those that require an acidic environment for proper absorption, such as certain antibiotics (e.g., tetracyclines) and thyroid medications. Therefore, taking calcium carbonate two hours before or after other medications helps to prevent such interactions.

C. "Place this medication underneath your tongue and let it dissolve":
Calcium carbonate is typically taken orally in tablet form, not sublingually. The medication should not be dissolved under the tongue, as it is not designed for that route of administration. This would be an incorrect instruction.

D. "You can take as many doses of this medication as you need":
This statement is not accurate. Calcium carbonate should be taken as prescribed and in the correct dosage to avoid side effects such as hypercalcemia or kidney stones. Overuse of calcium supplements can lead to serious complications, and it should not be taken "as needed" without specific instructions from the healthcare provider.