A nurse is preparing to administer clindamycin 500 mg by intermittent IV bolus over 30 min to a patient who has a staphylococci infection. Available is clindamycin premixed in 100 ml 0.9% sodium chloride (NaCl). The nurse should set the IV 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.) Fill in the Blank

To determine the infusion rate, we first need to calculate the mL/hr by dividing the total volume of the medication (100 mL) by the infusion time (30 minutes) and then multiplying by 60 to convert minutes to hours:

A. The partial thromboplastin time is 30 seconds:

The partial thromboplastin time (PTT) measures the clotting time of blood and is typically used to monitor patients on heparin therapy, not warfarin. A PTT of 30 seconds is within the normal range and does not directly relate to warfarin therapy. Therefore, it does not require immediate follow-up in the context of warfarin administration.

B. The International normalized ratio is 6.0:

The International Normalized Ratio (INR) is a standard measure used to monitor the effectiveness of warfarin therapy. For most indications, the therapeutic range for INR is typically between 2.0 and 3.0. A value of 6.0 indicates that the patient's blood is taking six times longer to clot than normal, suggesting a significantly increased risk of bleeding. Therefore, this result requires immediate follow-up by the nurse to assess the patient's condition and potentially adjust warfarin dosage to reduce the risk of bleeding.

C. Creatinine is 12:

Creatinine is a waste product generated by muscle metabolism and is filtered out of the blood by the kidneys. Elevated levels of creatinine may indicate impaired kidney function, but this result does not directly relate to warfarin therapy. While an elevated creatinine level may require follow-up for other reasons, it does not necessitate immediate action related to warfarin therapy.

D. The patient's hematocrit level is 43%:

Hematocrit is a measure of the proportion of red blood cells in the blood. A hematocrit level of 43% is within the normal range for both men and women and does not directly relate to warfarin therapy. While changes in hematocrit may occur in some patients taking warfarin, this result alone does not require immediate follow-up in the context of warfarin administration.

A. Monitors the patient's temperature, heart rate, respiratory rate, and blood pressure:
Monitoring vital signs is crucial for assessing the patient's overall condition, including respiratory status. However, while changes in vital signs may indicate respiratory distress, they do not directly address the need to ensure clear breath sounds. This intervention alone does not actively promote airway clearance or improve breath sounds.

B. Educates the patient to avoid handling pet excreta or cleaning litter boxes, birdcages, or aquariums:
This intervention focuses on reducing the risk of exposure to potential pathogens that could worsen the patient's respiratory condition. While important for infection control, it does not directly address the need to ensure clear breath sounds. Environmental precautions, although necessary, do not actively promote airway clearance or improve breath sounds.

C. Encourages the patient to perform cough, deep breathing, and postural drainage every 2 to 4 hours:
This intervention directly targets promoting airway clearance and improving breath sounds in a patient with pneumonia. Coughing helps mobilize secretions, deep breathing promotes lung expansion and ventilation, and postural drainage assists in the drainage of secretions from different lung segments. Regular performance of these interventions prevents secretion accumulation, thereby improving breath sounds and respiratory function.

D. Provides nutritional support if the patient is unable to take sufficient amounts by mouth:
While nutritional support is important for overall patient care, especially during illness or compromised nutritional intake, it does not directly address the need to ensure clear breath sounds in a patient with pneumonia. Although adequate nutrition supports immune function and overall recovery, it does not directly impact respiratory clearance or breath sounds.