A nurse is preparing to administer total parental nutrition (TPN) 1800 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 if it applies. Do not use a trailing zero.)

A. The client demonstrated an allergic response to the medication: While allergic reactions to disulfiram can occur, severe nausea and vomiting after taking the medication are more likely due to its interaction with alcohol rather than an allergic response.

B. The client consumed alcohol while taking the medication: Disulfiram is used to deter alcohol consumption by causing unpleasant reactions when alcohol is ingested. Severe nausea and vomiting are common adverse effects of consuming alcohol while on disulfiram.

C. The client took an overdose of the medication: An overdose of disulfiram could potentially lead to severe adverse effects, but nausea and vomiting alone are not typically indicative of an overdose.

D. The client experienced a common side effect of the medication: While nausea and vomiting are common side effects of disulfiram, they are typically experienced in response to alcohol consumption rather than as direct effects of the medication itself.

A. Insert the needle slowly and gently.

This statement is generally true for most injection techniques, including the Z-track method. Slow and gentle insertion helps minimize discomfort for the client and allows for better control over the needle's placement. However, the specific speed of insertion may vary depending on the nurse's technique and the client's skin condition.

B. Pull the skin 1.3 cm (1/2 inch) to the side.

This statement is correct. The Z-track technique involves pulling the skin laterally (to the side) by approximately 1.3 cm (1/2 inch) before inserting the needle. This lateral displacement of the skin creates a zigzag pathway for the medication, which helps prevent leakage or tracking of the medication along the injection site.

C. Aspirate for 5 to 10 seconds.

Aspiration, or pulling back on the plunger of the syringe after needle insertion, is not typically recommended for intramuscular injections, including those using the Z-track method. Aspiration may increase the risk of tissue trauma or damage to blood vessels. Since the Z-track technique is designed to minimize medication leakage into the subcutaneous tissue, aspiration is usually unnecessary.

D. Use a 45° angle of insertion.

The angle of insertion for the Z-track technique is typically 90 degrees (perpendicular) to the skin surface rather than 45 degrees. This angle allows for proper depth penetration into the muscle and ensures adequate delivery of the medication into the muscle tissue.