A nurse is preparing to administer ampicillin/sulbactam 1.5 g via intermittent IV bolus.

Available is ampicillin/sulbactam 1.5 g in 0.9% sodium chloride 100 mL to infuse over 30 min.

The nurse should set the IV infusion pump to deliver how many mL/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

Magnesium levels within the normal range of 1.3 to 2.1 mEq/L do not directly indicate a therapeutic response to sodium polystyrene sulfonate. This medication is primarily used to exchange potassium ions for sodium ions in the gastrointestinal tract, thus lowering serum potassium. Magnesium homeostasis is regulated independently, often by renal excretion and dietary intake, and is not a direct target of this drug.

Choice B rationale

Calcium levels within the normal range of 9 to 10.5 mg/dL do not indicate a therapeutic response to sodium polystyrene sulfonate. This medication does not significantly impact calcium metabolism. Calcium regulation involves parathyroid hormone and vitamin D, and is separate from the ion-exchange mechanism of sodium polystyrene sulfonate.

Choice C rationale

Sodium levels within the normal range of 136 to 145 mEq/L, while desirable, do not directly indicate a therapeutic response to sodium polystyrene sulfonate. Although the medication exchanges potassium for sodium, leading to a potential increase in serum sodium, the primary therapeutic goal is potassium reduction, and a normal sodium level alone does not confirm this.

Choice D rationale

A potassium level of 4.8 mEq/L, which falls within the normal range of 3.5 to 5 mEq/L, indicates a therapeutic response to sodium polystyrene sulfonate. This medication functions as a cation-exchange resin, binding to potassium ions in the intestine and facilitating their excretion, thereby lowering elevated serum potassium levels to a safe range.

Choice A rationale

Administering aspirin for fever in a client receiving alteplase is contraindicated. Alteplase is a potent thrombolytic, and aspirin, an antiplatelet agent, would significantly increase the risk of bleeding. If fever is present, acetaminophen would be the preferred antipyretic due to its lack of antiplatelet activity, minimizing the risk of hemorrhage in this high-risk patient.

Choice B rationale

Ambulation is contraindicated in a client receiving thrombolytic therapy. Alteplase lyses existing clots, increasing the risk of bleeding, especially from sites of trauma or increased pressure. Maintaining bed rest and limiting movement helps to minimize the risk of hemorrhagic complications, such as hematoma formation or internal bleeding, which could be exacerbated by physical activity.

Choice C rationale

Administering a sodium phosphate enema is contraindicated in a client receiving thrombolytic therapy. Sodium phosphate enemas can cause rectal irritation, mucosal injury, and increased peristalsis, all of which elevate the risk of gastrointestinal bleeding in a patient whose coagulation cascade is already significantly impaired by alteplase. Stool softeners are preferred if constipation is present.

Choice D rationale

Monitoring for changes in the level of consciousness is a critical intervention for a client receiving alteplase. Intracranial hemorrhage is the most serious and life-threatening complication of thrombolytic therapy. Any alterations in neurological status, such as confusion, disorientation, or decreased responsiveness, could indicate intracranial bleeding and necessitate immediate intervention and discontinuation of the infusion.