A nurse is assisting with care of a client who has a prescription for 3,000 mL of intravenous fluids over the next 24 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round to the nearest whole number)

A. By assessing the temperature every 4 hours:

Monitoring temperature every 4 hours is a common practice in hospitalized patients to detect fever, which could indicate an infection or an inflammatory response. However, this method does not directly assess the therapeutic blood levels of vancomycin. Fever alone does not provide specific information about the effectiveness or concentration of the antibiotic in the bloodstream.

B. By repeating a culture and sensitivity test on day 3:

Culture and sensitivity tests involve taking a sample from the patient (such as blood, urine, or sputum) and growing the microorganisms in a laboratory to identify the causative organism and determine its susceptibility to antibiotics. While this test is essential for identifying the appropriate antibiotic therapy initially, repeating it on day 3 does not directly monitor therapeutic blood levels of vancomycin. It also doesn't provide real-time information about the concentration of vancomycin in the bloodstream.

C. By obtaining drug peak and trough levels:

This choice involves measuring the highest (peak) and lowest (trough) concentrations of vancomycin in the bloodstream. Peak levels are typically measured about 1 hour after the completion of a vancomycin infusion, while trough levels are measured just before the next dose is administered. These measurements allow healthcare providers to ensure that the drug concentration remains within the therapeutic range to effectively treat the infection while minimizing the risk of toxicity.

D. By assessing for breathlessness:

Assessing for breathlessness is important for monitoring respiratory status, particularly in patients receiving vancomycin, as rare side effects like red-man syndrome or anaphylaxis can cause respiratory distress. However, this method does not directly monitor therapeutic blood levels of vancomycin.

A.Alcohol:

Alcohol consumption does not directly reduce the absorption of ciprofloxacin. However, alcohol can interact with certain medications and may exacerbate side effects such as dizziness, drowsiness, and gastrointestinal upset. It’s generally advisable to avoid excessive alcohol consumption while taking ciprofloxacin, but alcohol itself does not significantly affect the absorption of the medication.

B. Intense physical exertion:

Intense physical exertion is unlikely to directly reduce the absorption of ciprofloxacin. However, gastrointestinal motility may increase during intense exercise, potentially affecting the absorption of oral medications. In some cases, gastrointestinal disturbances associated with physical exertion may affect the absorption of ciprofloxacin, but this effect is generally minor and not a significant concern for most individuals.

C. Fruit juices, in particular grapefruit juice:

Grapefruit juice is known to interact with certain medications by inhibiting intestinal enzymes responsible for drug metabolism, leading to increased drug concentrations in the bloodstream. However, ciprofloxacin is not significantly affected by grapefruit juice. In fact, fruit juices, including grapefruit juice, are generally not known to reduce the absorption of ciprofloxacin.

D. Antacids or mineral supplements:

Antacids and mineral supplements containing aluminum, magnesium, calcium, or iron can significantly reduce the absorption of ciprofloxacin when taken concurrently. These substances can form complexes with ciprofloxacin in the gastrointestinal tract, reducing its bioavailability. Therefore, it’s recommended to avoid taking antacids or mineral supplements containing these minerals within a few hours before or after taking ciprofloxacin to avoid interference with its absorption.