A client receives a prescription for 500 mL of lactated Ringer's IV to be infused over 4 hours. The IV administration set delivers 20 gtt/mL. How many gtt/min should the nurse regulate the infusion? (Enter numerical value only. If rounding is required, round to the nearest whole number.)

Rationale:

1. Calculate total fat calories for each day:
   • Day 1: 24×38=91224 \times 38 = 912 kJ
   • Day 2: 22×38=83622 \times 38 = 836 kJ
   • Day 3: 23×38=87423 \times 38 = 874 kJ
2. Convert total daily calories to kJ:
   • Day 1: 3,200×4.184=13,388.83,200 \times 4.184 = 13,388.8 kJ
   • Day 2: 2,980×4.184=12,471.32,980 \times 4.184 = 12,471.3 kJ
   • Day 3: 3,310×4.184=13,841.03,310 \times 4.184 = 13,841.0 kJ
3. Calculate fat percentage:
   • Day 1: (912/13388.8)×100=18.2%
   • Day 2: (836/12471.3)×100=17.1%
   • Day 3: (874/13841.0)×100=17.3%

Average fat percentage: (18.2+17.1+17.3)/3=17.5%

1. Interpretation:
   • The recommended fat intake range is 20-35% of total calories.
   • The client's fat intake is 14-19%, which is below the recommended range.
   • The client should increase his fat intake to meet nutritional needs.

A. Muscle aches and pains. Muscle pain is not a primary concern related to melanoma recurrence. While melanoma can metastasize to other organs, localized muscle pain is not the most important characteristic to monitor post-resection.
B. Appearance of any moles. Malignant melanoma is strongly associated with abnormal moles. The client should monitor existing moles and new skin lesions using the ABCDE rule:Asymmetry, Border irregularity, Color variation, Diameter greater than 6 mm, Evolving changes (size, shape, or symptoms like itching or bleeding), Early detection of new or changing moles is critical for identifying recurrence or new melanoma development.
C. Pigmentation of the skin. Changes in overall skin pigmentation (such as tanning or lightening) are not a primary concern. Localized pigmentation changes around moles may indicate malignancy, but generalized pigmentation shifts are not the focus for melanoma monitoring.
D. Elasticity of the skin. Skin elasticity is affected by aging and sun exposure but is not a key factor in melanoma surveillance. Monitoring moles and skin lesions is far more important for early detection of recurrence.