A nurse is caring for a client who has a prescription for lactated Ringer's IV 4,080 mL/24 hr. The nurse should set the IV infusion pump to deliver how many mL/hr to administer half the total volume in the first 8 hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Choice A rationale:

Changing the inner cannula on a tracheostomy is within the legal scope of practice for registered nurses. Nurses are trained to perform tracheostomy care, including changing the inner cannula. This procedure is within the nursing scope of practice and does not require a physician's intervention.

Choice B rationale:

Inserting a tunneled central venous catheter (such as a Hickman line) is a specialized procedure that generally falls under the scope of practice for advanced practice nurses (such as nurse practitioners or clinical nurse specialists) or physicians. RNs typically do not have the required training or authority to perform this invasive procedure.

Choice C rationale:

Irrigation of an external ear canal is within the legal scope of practice for registered nurses. Ear irrigation is a common nursing procedure used to remove impacted cerumen (earwax) and foreign bodies from the ear canal. Nurses are trained to perform this procedure safely and effectively.

Choice D rationale:

Administering blood products, including platelet transfusions, is within the legal scope of practice for an RN. RNs are responsible for preparing, verifying, and administering blood products according to institutional policies and procedures. This includes monitoring the patient during and after the transfusion for any adverse reactions.

A. Incorrect. Encouraging the client to watch television might not provide the calming presence and support needed during a panic attack.

B. Correct. Sitting with the client and providing a sense of security can help them feel more grounded and supported during the panic attack.

C. Incorrect. Atomoxetine is not typically used to treat acute panic attacks. It's a medication used for attention deficit hyperactivity disorder (ADHD).

D. Incorrect. Teaching the client how to meditate might be beneficial in the long term, but during an acute panic attack, the client may not be receptive to learning new techniques.