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.)

Answer: D. "I’ll take this medicine first thing in the morning."

A. "I should expect to feel better after 24 hours of starting this medication."
This statement indicates a misunderstanding of the medication's pharmacodynamics. Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), generally requires a minimum of 4 to 6 weeks to exhibit therapeutic effects in treating depression. Clients may initially experience side effects, such as nausea or changes in sleep patterns, before noticing any improvement in mood. It's crucial to educate clients about this timeline to manage expectations and encourage adherence to the medication regimen.

B. "I should not take this medicine with grapefruit juice."
This statement is incorrect. While grapefruit juice can affect the metabolism of many medications due to its action on cytochrome P450 enzymes, fluoxetine is not significantly impacted by grapefruit juice. Therefore, clients can consume grapefruit juice without the risk of altering the effectiveness or safety of fluoxetine. Providing accurate dietary information is essential to ensure clients feel confident in their dietary choices while on medication.

C. "I’ll take this medicine with food."
While clients may take fluoxetine with food to help minimize potential gastrointestinal upset, it is not strictly necessary. The medication can be effective whether taken with or without food. This flexibility allows clients to choose the method that works best for their individual tolerance and lifestyle, which can improve adherence and comfort.

D. "I’ll take this medicine first thing in the morning."
This is the correct understanding. Taking fluoxetine in the morning is generally recommended because the medication can cause insomnia or increased alertness in some individuals, particularly when initiated. By taking it in the morning, clients can avoid potential sleep disturbances at night, which is important for maintaining a regular sleep-wake cycle and overall well-being. Additionally, consistent timing can help improve adherence to the treatment plan.

B. "Describe what the pill looks like":

This is the correct response. Asking the client to describe the pill they usually take helps to verify whether the medication being administered matches the client's usual medication. It allows the nurse to confirm whether the client's concern is due to a legitimate difference in appearance or if there might be a potential medication error.

A. "This pill is probably from a different lot number than yours at home":

While lot numbers can vary between batches of medication, this response does not directly address the client's concern about the difference in appearance. It's important to prioritize addressing the client's immediate concerns and verifying the medication's identity.

C. "This hospital might use a different manufacturer, but the medication is the same":

While this response reassures the client about the medication's efficacy, it does not directly address the client's concern about the difference in appearance. Verifying the medication's identity based on the client's description is essential before proceeding with administration.

D. "This is the medication prescribed by your provider":

This response does not address the client's concern about the difference in appearance and may not alleviate their apprehension. Verifying the medication's identity based on the client's description is necessary to ensure the correct medication is administered.