A nurse is preparing to infuse a 250-mL unit of packed red blood cells (RBCs) over 2 hours.

The drop factor of the manual intravenous (IV) tubing is 15 drops/mL. How many drops per minute should the nurse adjust the flow rate to deliver?

Choice A rationale

Excessive thirst and urination are symptoms of hyperglycemia, not hypoglycemia. Hyperglycemia could occur if the TPN solution was infusing too quickly, but it would not be a result of the infusion pump not working.

Choice B rationale

Shakiness and diaphoresis are manifestations of hypoglycemia. When a sudden interruption in the infusion of TPN occurs, the patient is at risk for hypoglycemia.

Choice C rationale

Fever and chills are symptoms of infection, not a direct result of the TPN infusion stopping.

Choice D rationale

Hypertension and crackles in the lungs are signs of fluid overload, not hypoglycemia. These symptoms would not be expected if the TPN infusion stopped.

Choice A rationale

Emptying the drainage bag when half full is a correct action by the AP4. It is important to empty the drainage bag regularly to prevent infection and maintain accurate intake and output records.

Choice B rationale

Placing the drainage bag on the side rail of the patient’s bed is an incorrect action by the AP4. The drainage bag should be placed below the level of the bladder to prevent backflow of urine, which can lead to infection.

Choice C rationale

Kinking the catheter tubing to obtain a urine specimen is an incorrect action by the AP4. This can cause discomfort to the patient and potentially damage the catheter.

Choice D rationale

Securing the catheter tubing to the patient’s thigh is a correct action by the AP4. This helps to prevent pulling on the catheter, which can cause discomfort and potential damage to the urethra.