A nurse is caring for a client who is taking warfarin and reports taking several new herbal supplements. The nurse should identify that which of the following supplements is contraindicated for concurrent use with warfarin?

Let's break down the steps:

Total volume to be delivered: We know the volume of the sodium chloride solution is 100 ml.

Concentration of cefazolin: The concentration is given as 1 gram of cefazolin in 100 ml of solution. Therefore, the concentration is 1 g / 100 ml = 0.01 g/ml.

Delivery time: The infusion needs to be delivered over 30 minutes, which is 0.5 hours (since 1 hour = 60 minutes).

Drop factor: The drop factor is 15 gtt/ml, which tells us how many drips it takes to deliver 1 ml of fluid.

Now, we can calculate the rate (flow rate) of the infusion in gtt/min:

Rate = (Total volume) / (Delivery time)

Rate = (100 ml) / (0.5 hours) = 200 ml/hour

Since we know the drop factor, we can convert the rate from ml/hour to gtt/min:

Rate (gtt/min) = Rate (ml/hour) * Drop factor (gtt/ml)

Rate (gtt/min) = 200 ml/hour * 15 gtt/ml = 3000 gtt/hour

Finally, round the rate to the nearest whole number:

Rate (rounded gtt/min) = 3000 gtt/hour ≈ 50 gtt/min

Therefore, the nurse should set the manual IV infusion to deliver approximately 50 gtt/min.

A) Pain level:
Assessing the pain level may be important before administering certain medications, particularly analgesics or pain-relieving medications. However, propranolol is a beta-blocker primarily used to treat conditions such as hypertension, angina, and certain cardiac arrhythmias. Therefore, assessing pain level is not directly related to the administration of propranolol.

B) Temperature:
Assessing temperature may be relevant in various clinical situations, such as when evaluating for signs of infection or fever. However, it is not typically a specific assessment required before administering propranolol, unless there are specific concerns related to the client's condition that necessitate temperature monitoring.

C) Respiratory rate:
Assessing respiratory rate is an important part of a comprehensive respiratory assessment, especially in clients with respiratory conditions or those at risk of respiratory depression. However, propranolol is not known to directly affect respiratory rate, and routine assessment of respiratory rate may not be required before administering this medication in most cases.

D) Heart rate:
Correct. Propranolol is a beta-blocker that primarily works by blocking beta-adrenergic receptors, which leads to a reduction in heart rate and blood pressure. Therefore, it is essential to assess the client's heart rate before administering propranolol, as the medication's dosage and timing may need adjustment based on the client's heart rate at the time of administration. Additionally, propranolol is often used to manage conditions such as tachycardia and hypertension, where heart rate assessment is crucial for monitoring treatment effectiveness.