A nurse is caring for a client in the ICU. The client's ECG monitor tracing reveals sinus bradycardia and S-T segment elevation. The client reports shortness of breath and feeling dizzy and faint. Which of the following medications should the nurse administer?

The nurse should administer a total 1320ml sodium chloride in the first hour, 880ml each subsequent hour.

Rationale

First Hour Administration

Rate: 15 ml/kg/hr Client's weight: 88 kg

Calculation: 15 ml/kg/hr × 88 kg= 1320ml/hr

Therefore, in the first hour, the nurse should administer 1320 mL of 0.9% sodium chloride.

Subsequent Hour Administration

Rate: 10 ml/kg/hr Client's weight: 88 kg

Calculation: 10 ml/kg/hr × 88kg= 880mls

Therefore, each subsequent hour after the first, the nurse should administer 880 mL of 0.9% sodium chloride.

B. Slowing the infusion rate of 0.9% sodium chloride and contacting the provider are appropriate initial actions to manage the client's dyspnea and hypertension, which are likely due to fluid overload from the IV infusion.

A Corticosteroids are not typically indicated for dyspnea and hypertension related to IV fluid administration with 0.9% sodium chloride.

C Changing the type of IV fluid to lactated Ringer's solution may be considered in some cases to address fluid balance issues. However, this decision should be made in consultation with the healthcare provider based on the client's specific clinical condition and fluid status.

D. Lowering the head of the bed to semi-Fowler's position can help improve respiratory function and reduce dyspnea. However, this action alone does not address the underlying cause of the client's symptoms.