A patient has been prescribed 1 L of Lactated Ringer’s IV to be infused over a 12-hour period.

The IV administration set delivers 15 gtt/mL. What should be the infusion rate in gtt/min? (Provide a numerical value only.

If rounding is required, round to the nearest whole number.)

Choice A rationale

The patient’s history indicates that she had difficulty breathing during a hike. This event led her to the emergency department. Difficulty breathing during physical activity such as hiking can be a symptom of an asthma exacerbation.

Choice B rationale

While severe allergic reactions can cause difficulty breathing, the patient’s history does not indicate that she experienced an allergic reaction prior to her emergency department visit.

Choice C rationale

Panic attacks can cause symptoms such as rapid heart rate, sweating, and shortness of breath. However, the patient’s history does not indicate that she had a panic attack prior to her emergency department visit.

Choice D rationale

Fainting, or loss of consciousness, can be caused by various conditions, including dehydration, low blood sugar, and heart problems. However, the patient’s history does not indicate that she fainted prior to her emergency department visit.

Choice A rationale

Exenatide is a medication used to improve blood sugar control in adults with type 2 diabetes. One of the potential side effects of exenatide is pancreatitis, which can cause severe abdominal pain. Therefore, patients should be instructed to notify their healthcare provider if they start having abdominal pain after starting exenatide.

Choice B rationale

Exenatide should be injected within 60 minutes (1 hour) before the morning and evening meal (or before the two main meals of the day, at least 6 hours apart), not 30 minutes before or after a meal. Therefore, this instruction is incorrect.

Choice C rationale

Exenatide does not act in the same way as insulin. While both insulin and exenatide help to control high blood sugar, they work in different ways. Insulin allows sugar in your blood to enter your cells, while exenatide works by increasing the release of insulin when blood sugar levels are high, decreasing the amount of glucose produced and released by the liver, and slowing gastric emptying.

Choice D rationale

There are precautions about taking exenatide with other medications. For example, exenatide may affect the absorption of some orally administered drugs due to its effect on gastric emptying. Therefore, patients should be advised to take oral medications that require rapid absorption at least 1 hour before injecting exenatide.