A client receives a prescription for ciprofloxacin 400 mg intravenously (IV) every 12 hours to be infused over an hour. The IV bag contains ciprofloxacin 400 mg in dextrose 5% in water (DW) 200 mL. The nurse should program the infusion pump to deliver how many mL/hr? (Enter numerical value only.)

When a client in the surgical recovery area asks for the largest possible dose of pain medication, the nurse should implement the following action first:

A. Ask the client to rate the current level of pain using a pain scale.

Explanation: Before administering pain medication, it is essential to assess the client's current level of pain. Using a pain scale allows the nurse to understand the severity of the pain and tailor the medication dosage accordingly. This assessment helps ensure that the client receives an appropriate and safe dose of pain medication.

Why the other choices are not the first action to take:

B. Review the history for a past use of recreational drugs:

While assessing a client's history, including past drug use, is important, it is not the immediate priority when a client is requesting pain medication. Pain assessment and management should come first.

C. Encourage the client to use diversional thoughts to manage pain:

Diversional thoughts and non-pharmacological pain management strategies can be helpful, but they should not be the initial response when a client is in acute pain and requesting medication.

D. Determine when the last dose was administered:

While it is important to know when the last dose of pain medication was given, this information is typically obtained after assessing the client's current pain level. Assessing pain intensity and then reviewing medication history and administration times is a logical sequence of actions.

A. Unpleasant smell when using the medication:

While acetylcysteine has a distinctive odor, this is not the primary therapeutic response to expect. The odor is often described as unpleasant or sulfur-like.

B. Bronchodilation and wheezing:

Acetylcysteine is not primarily used for bronchodilation. It is used to thin mucus and facilitate its removal. Wheezing is not a common response to acetylcysteine.

When administering acetylcysteine via nebulization through an endotracheal tube to a client with pneumonia, the nurse should expect the following therapeutic response:

C. Increased sputum, requiring suctioning.

Explanation: Acetylcysteine is a mucolytic agent used to help thin and loosen mucus in the airways, making it easier to clear secretions. When administered via nebulization, it can stimulate increased mucus production, which may result in the client needing suctioning to remove the loosened secretions. This is a desired therapeutic effect because it helps clear the airways and improve lung function in clients with conditions like pneumonia.

D. Hypotension:

Hypotension is not a common or expected therapeutic response to acetylcysteine. It is important to monitor blood pressure during administration, but hypotension is not the primary effect of this medication.