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A patient is prescribed 500 ml of Normal Saline to be infused over 90 minutes. The drop factor on the tubing is 10 gtt/mL. At what rate should the nurse regulate the IV (gtt/min)? (Round to the nearest whole number)

Answer and Explanation

The Correct Answer is ["56"]

Calculate the infusion rate in mL/min.

The total volume to be infused is 500 mL.

The infusion time is 90 minutes.

The infusion rate = 500 mL / 90 minutes = 5.5556 mL/min.

Calculate the drip rate in gtt/min.

The drop factor is 10 gtt/mL.

We need to deliver 5.5556 mL/min.

To find the drip rate, we can set up a proportion:

10 gtt / 1 mL = x gtt / 5.5556 mL

Cross-multiplying:

x = 10 gtt/mL x 5.5556 mL = 55.5556 gtt

Round the answer to the nearest whole number.

56 gtt/min.

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Correct Answer is B

Explanation

A. and record vital signs every 4 hours:
While vital signs are important, monitoring every 4 hours may not be frequent enough in an intensive care setting, especially for a client requiring mechanical ventilation. Vital signs, including blood pressure, heart rate, respiratory rate, and oxygen saturation, should be monitored more frequently (at least every hour) to detect changes in the patient's condition, particularly since positive pressure ventilation can significantly affect circulatory status.

B. Intake and output hourly:
In acute respiratory distress syndrome (ARDS), the client may require mechanical ventilation to support breathing. Positive pressure ventilation, while essential for improving oxygenation, can increase intrathoracic pressure, which may impair venous return to the heart, decreasing cardiac output. As a result, it is critical to monitor the fluid balance closely, as fluid overload can worsen the patient's condition and contribute to pulmonary edema or other complications. Hourly assessment of intake and output (I&O) helps the nurse monitor renal function, fluid status, and cardiac output. Maintaining a proper balance of fluids is crucial in managing ARDS and its associated complications.

C. Heart and lung sounds every shift:
A shift assessment of heart and lung sounds is useful but is not frequent enough to detect early changes in a client with decreased cardiac output or other complications related to mechanical ventilation. More frequent monitoring of lung sounds and heart function may be necessary, particularly in clients at risk of ventilator-associated complications like ventilator-associated pneumonia (VAP), pulmonary edema, or arrhythmias.

D. Level of consciousness every shift:
Monitoring level of consciousness is important, especially in clients with ARDS and mechanical ventilation, as changes in consciousness can indicate worsening hypoxia or hypercapnia. However, this assessment is less directly related to the immediate concern of decreased cardiac output, which can be more effectively managed through continuous monitoring of fluid status and vital signs rather than consciousness alone. Though consciousness should be monitored regularly, I&O hourly would be more crucial in this context for managing cardiac output.

Correct Answer is ["3.9"]

Explanation

Step-by-Step Solution:

Convert the toddler's weight from pounds to kilograms.

1 pound is =0.453592 kilograms.

So, 26 pounds = 26 x 0.453592 = 11.793592 kilograms.

Calculate the total daily dose of prednisolone.

The prescribed dose is 2 mg/kg/day.

The toddler weighs 11.793592 kg.

The total daily dose = 2 mg/kg/day x 11.793592 kg = 23.587184 mg/day.

Determine the dose per administration.

The total daily dose is divided into two equal doses (every 12 hours).

The dose per administration = 23.587184 mg/day / 2 = 11.793592 mg per dose.

Calculate the volume of prednisolone syrup to administer.

The available prednisolone syrup is 15 mg/5 ml.

We need to administer 11.793592 mg per dose.

To find the volume, we can set up a proportion:

15 mg / 5 ml = 11.793592 mg / x ml

Cross-multiplying:

15x = 5 x 11.793592

Solving for x:

x = (5 x 11.793592) / 15 = 3.931197 ml

Round the answer to the nearest tenth.

3.9 ml.

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A patient is prescribed 500 ml of Normal Saline to be infused over 90 minutes. The drop factor on the tubing is 10 gtt/mL. At what rate should the nurse regulate the IV (gtt/min)? (Round to the nearest whole number)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client diagnosed with acute respiratory distress syndrome (ARDS) who requires mechanical ventilation. A client problem of decreased cardiac output from the positive pressure ventilator has been identified. What should the nurse include in the plan of care? Assess:

Correct Answer is B

Explanation

A client is receiving a continuous infusion of IV insulin at 8 mL/hour. Pharmacy makes an infusion of 75 units of regular insulin in 150 mL of Normal Saline for this institution. How many units per hour is the client receiving? (Round to the nearest whole number)

Correct Answer is ["3.9"]

Explanation

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