A client is to receive 250 mL of IV fluid over 90 minutes by gravity.

The drop factor on the IV tubing is 20 gtts/mL. How many gtts/min should be administered?

Answer and Explanation

The Correct Answer is ["56"]

Step 1 is (250 mL ÷ 90 min) × 20 gtt/mL.

Step 2 is (2.777 mL/min × 20 gtt/mL).

Step 3 is 55.55 gtts/min. The final calculated answer is 56 gtts/min.

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Correct Answer is B

Explanation

Choice A rationale

Administering oxygen at 6 liters per minute via nasal cannula risks hypercapnia in a client with emphysema due to impaired CO2 elimination. Oxygen should be titrated to maintain safe saturation levels, usually 88–92%.

Choice B rationale

Ipratropium is a bronchodilator that safely alleviates airway constriction in emphysema without systemic cardiovascular effects, making it suitable for a client with coronary artery disease and chronic obstructive pulmonary conditions.

Choice C rationale

Propranolol is contraindicated in emphysema due to its beta-blocking effects, which may exacerbate bronchoconstriction and reduce respiratory function, posing a significant risk to the client’s health.

Choice D rationale

Organic herbal supplements lack evidence-based safety and efficacy, especially in complex medical conditions like coronary artery disease and emphysema. They can also interact adversely with prescribed medications.

A. Elevate the head of the bed, loosen clothing, check the urinary catheter for obstruction. B. Elevate the head of the bed and apply a cool compress to the forehead. C. Establish IV access, apply 2L of oxygen via nasal cannula, notify provider. D. Place in supine position and establish IV access for medication administration.

Correct Answer is A

Explanation

Choice A rationale

Elevating the head of the bed reduces blood pressure and intracranial pressure. Loosening restrictive clothing addresses triggers of autonomic dysreflexia, while checking the catheter resolves bladder-related stimulus for this medical emergency.

Choice B rationale

Although elevating the head of the bed is correct, applying a cool compress doesn't address the root cause of autonomic dysreflexia. The compress offers temporary relief without resolving the underlying triggers.

Choice C rationale

IV access and oxygen application are secondary interventions. The priority is resolving triggers like bladder distension or tight clothing to prevent further autonomic dysreflexia complications.

Choice D rationale

Placing the patient in a supine position can exacerbate hypertension and intracranial pressure. This positioning fails to address triggers of autonomic dysreflexia and is contraindicated in this condition. .

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A client is to receive 250 mL of IV fluid over 90 minutes by gravity. The drop factor on the IV tubing is 20 gtts/mL. How many gtts/min should be administered?

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A client is to receive 250 mL of IV fluid over 90 minutes by gravity.

The drop factor on the IV tubing is 20 gtts/mL. How many gtts/min should be administered?