A nurse is preparing to administer lidocaine via continuous IV infusion at 4 mg/min. Available is lidocaine 2 g dextrose 5% in water 500 mL. 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.)

Choice A Reason:
Contact the provider to clarify the prescription is not appropriate. Contacting the provider might not be necessary in this case. The prescription specifies "NOW," indicating an urgent administration, which is a clear directive to administer the medication promptly without further clarification.
Choice B Reason:
Administer the medication within 90 minutes is appropriate. "NOW" typically implies an urgent need for administration, and within a hospital setting, "NOW" often indicates a timeframe of around 90 minutes for prompt administration of the medication.
Choice C Reason:
Notify the pharmacy to send the medication immediately is inappropriate. With the prescription stating "NOW," the need for immediate administration usually requires using the hospital's available stock of the medication rather than waiting for delivery from the pharmacy. This action might cause a delay in administration.
Choice D Reason:
Inform the client there is a prescription available if needed is inappropriate. This option is not suitable in this scenario. "NOW" in the prescription implies the immediate need for administration, so informing the client about the availability of the prescription doesn't align with the urgency implied by the directive "NOW."

Choice A Reason:
Bone loss is correct. Prednisone, a corticosteroid, can lead to decreased bone density (osteoporosis) over extended periods of use, particularly in older adults. This adverse effect increases the risk of fractures and bone-related issues due to the drug's impact on bone health and calcium absorption.
Choice B Reason:
Liver toxicity is incorrect. While prednisone can affect liver function tests in some cases, it is less commonly associated with significant liver toxicity compared to other medications. However, liver function should be monitored during prolonged use.
Choice C Reason:
Hemolytic anemia is incorrect. Prednisone is not typically associated with causing hemolytic anemia as an adverse effect.
Choice D Reason:
Hypoglycemia is not a common adverse effect associated with prednisone use. In fact, prednisone can elevate blood sugar levels and may lead to hyperglycemia or exacerbate diabetes in susceptible individuals.