A client with severe nausea has a one time order for ondansetron (Zofran) 8 mg IVPB to be administered over 15 minutes. The medication is diluted in 50 mL of D5W. The tubing drop factor is 15 gtt/mL. How many drops per minute should be given?

A. Coronary artery disease (CAD):

Coronary artery disease primarily affects the blood vessels supplying the heart muscle. Symptoms often include chest pain (angina) rather than pain in the lower extremities. The symptoms described in the scenario are not characteristic of CAD.

B. Arterial embolus:

An arterial embolus is a blood clot or debris that travels through the bloodstream and can block an artery. While it can cause decreased blood flow and pain, the presentation in the lower left leg and foot with relief of pain at rest is more suggestive of peripheral arterial disease (PAD) or intermittent claudication rather than an acute arterial embolus.

C. Raynaud disease:

Raynaud's disease is characterized by episodes of reduced blood flow to the extremities, usually triggered by cold or stress. It typically involves color changes (white, blue, red) in the fingers or toes. The symptoms described, including pain in the lower leg and foot during walking, are not typical of Raynaud's disease.

D. Intermittent claudication:

Intermittent claudication is a symptom associated with peripheral arterial disease (PAD). It involves pain or cramping in the legs during physical activity, such as walking, due to reduced blood flow to the muscles. Rest typically relieves the pain. The observation of a hairless leg and slight edema suggests potential vascular compromise in the lower extremity, supporting the diagnosis of intermittent claudication.

A. “I will need to stop smoking because the nicotine causes less blood to flow to my hands and feet.”

Explanation: This statement reflects an understanding of the association between smoking and reduced blood flow, particularly due to nicotine's vasoconstrictive effects.

B. “The older I get the higher my risk for peripheral arterial disease gets.”

Explanation: While age is a non-modifiable risk factor for PAD, it is not a statement indicating a change in behavior to address risk factors. It is correct information but doesn't involve a proactive approach to risk reduction.

C. “Since my family is from Italy, I have a higher risk of developing peripheral arterial disease.”

Explanation: Family history is a non-modifiable risk factor, and the statement correctly identifies this risk factor. However, it doesn't address modifiable factors or actions to reduce risk.

D. “I will need to increase the amount of green leafy vegetables I eat to lower my cholesterol levels.”

Explanation: This statement demonstrates an understanding of a dietary modification to lower cholesterol levels, which is a positive step toward reducing a modifiable risk factor for PAD.