A nurse is preparing to administer total parental nutrition (TPN) 1000 mL to infuse over 24 hr. 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 fit applies. Do not use a trailing zero.)

A. Assess nutritional status with height, weight, blood urea nitrogen, transferrin, hemoglobin, and hematocrit level: This option focuses on assessing the patient's nutritional status, which is important for planning appropriate interventions. However, in a patient presenting with severe diarrhea and vomiting, the priority is to address immediate physiological needs and stabilize the patient's condition before conducting comprehensive assessments. While assessing nutritional status is important for long-term management, it is not the first action the nurse should take in this acute situation.

B. Consult with a dietitian to determine the patient's nutritional needs: Consulting with a dietitian is an important step in addressing the patient's nutritional needs, especially in cases of prolonged diarrhea and vomiting. However, in this scenario, the patient is experiencing severe symptoms that require immediate attention. Before consulting with a dietitian, the nurse should address the patient's acute symptoms and initiate interventions to manage fluid and electrolyte imbalances.

C. Encourage the patient to prepare simple meals or to obtain assistance with meal preparation if possible: This option addresses the immediate need to provide nutritional support to the patient. Encouraging the patient to consume simple, easily digestible meals or to seek assistance with meal preparation helps ensure that the patient receives adequate nutrition despite experiencing symptoms of diarrhea and vomiting. Providing practical advice on meal preparation empowers the patient to take control of their nutritional intake, which can be beneficial in managing symptoms and promoting recovery.

D. Encourage the patient to eat meals with visitors or others when possible: While social support and companionship can have a positive impact on the patient's overall well-being, including their nutritional intake, this option is not the first priority in this scenario. The patient's severe symptoms of diarrhea and vomiting require immediate attention to address fluid and electrolyte imbalances and prevent complications such as dehydration. Once the patient's condition stabilizes, encouraging social interaction during meals can be beneficial for promoting nutritional intake and emotional support.

A. "Has anyone in your family ever experienced symptoms similar to yours?":
This question aims to gather information about potential familial illnesses or infections but does not specifically address the possible etiology of human immunodeficiency virus (HIV). While HIV can be transmitted vertically from mother to child, asking about family members' symptoms is less directly relevant to the assessment of HIV exposure.

B. "How many alcoholic drinks do you typically consume in a week?":
This question assesses the patient's alcohol consumption habits and is important for evaluating overall health and potential risk factors for various conditions. However, it does not directly address the possible etiology of human immunodeficiency virus (HIV). Alcohol consumption may affect immune function but is not a primary indicator of HIV exposure.

C. "To the best of your knowledge, are your immunizations up to date?":
This question is aimed at assessing the patient's immunization status and is essential for preventive healthcare. However, it does not directly address the possible etiology of human immunodeficiency virus (HIV). Immunizations primarily protect against infectious diseases caused by bacteria or viruses other than HIV.

D. "Have you recently had unprotected intercourse with a new partner?":
This question directly addresses behaviors that could lead to HIV transmission. Unprotected sexual intercourse with a new partner is a significant risk factor for acquiring HIV, as the virus can be transmitted through sexual contact with an infected individual. Asking about recent sexual activity helps identify potential exposure to HIV and informs appropriate testing and counseling.