A client receives a prescription for dextrose 5% in water 500 mL IV to be infused over 4 hours. The IV administration set delivers 15 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.)

A) Avoid taking the medication on an empty stomach:
While it’s generally recommended to take lithium carbonate with food or milk to minimize gastrointestinal side effects, taking it on an empty stomach does not pose a significant risk. Therefore, it is not the most crucial instruction to emphasize to the client.

B) Maintain a fluid intake of 1,500 to 3,000 mL per day:
This instruction is crucial because lithium can cause dehydration, especially if the client becomes dehydrated due to increased sweating or decreased fluid intake. Adequate fluid intake helps maintain stable lithium levels in the blood and reduces the risk of toxicity. Emphasizing the importance of maintaining hydration is essential for clients taking lithium.

C) Report fluctuations in weight to the healthcare provider:
Weight fluctuations can indicate changes in fluid balance or other metabolic effects of lithium. While it’s important for the client to report changes in weight, this instruction is not as critical as ensuring adequate fluid intake, which directly affects lithium levels and toxicity risk.

D) Keep medication fliers for frequent review and reference:
While it’s helpful for clients to have medication information for reference, this instruction is more about general medication adherence and education rather than a specific requirement related to lithium carbonate.

A) Irrigation and topical antibiotic application to wound area: While wound care is important in managing infections, obtaining cultures before initiating antibiotic therapy takes precedence to ensure appropriate treatment. Topical antibiotics may not adequately address systemic infections caused by gram-negative bacteria.
B) Monitor for signs of sodium and fluid retention: This intervention is important when administering certain antibiotics, such as those in the aminoglycoside class, but it is not the most immediate priority. Monitoring for signs of sodium and fluid retention is typically indicated after antibiotic therapy has commenced and involves assessing the client's clinical status and laboratory values for signs of electrolyte imbalance or fluid overload.
C) Wound and blood specimens for culture and sensitivity: This action is essential before initiating antibiotic therapy because it allows for the identification of the specific organism causing the infection and its susceptibility to antibiotics. This information guides the selection of the most appropriate antibiotic for targeted therapy, improving treatment efficacy and reducing the risk of antibiotic resistance.
D) Complete blood count and serum electrolytes: While monitoring laboratory values is important in the overall management of the client, obtaining cultures for culture and sensitivity testing is the priority before initiating antibiotic therapy. This step helps ensure that the chosen antibiotic is effective against the specific pathogen causing the infection.