A postpartum client who is bottle-feeding develops breast engorgement. Which is the best recommendation for the nurse to provide this client?

Converting the weight to kg:
Client weight = 198 lbs 1 lb = 0.453592 kg

Client weight in kg = 198 lbs 0.453592 kg/lb = 90.7 kg
Calculating the desired dopamine infusion rate:
Dose = 2 mcg/kg/minute Client weight = 90.7 kg
Desired infusion rate = Dose Client weight = 2 mcg/kg/minute 90.7 kg = 181.4 mcg/minute

Determining the dopamine concentration in the bag:

Dopamine amount = 400 mg Bag volume = 250 mL
Dopamine concentration = Dopamine amount / Bag volume = 400 mg / 250 mL = 1.6 mg/mL
Convert mg/mL to mcg/mL: 1.6 mg/mL 1000 mcg/mg = 1600 mcg/mL

Calculating the rate in mL/minute:

Desired infusion rate = 181.4 mcg/minute Dopamine concentration = 1600 mcg/mL
Rate (mL/minute) = Desired infusion rate (mcg/minute) / Dopamine concentration (mcg/mL)
Rate = 181.4 mcg/minute / 1600 mcg/mL = 0.1134 mL/minute

Converting the rate to mL/hour:
Rate (mL/minute) = 0.1134 mL/minute Conversion factor: 60 minutes/hour
Rate (mL/hour) = 0.1134 mL/minute 60 minutes/hour = 6.8 mL/hour (round to nearest tenth)

Therefore, the nurse should set the IV pump to deliver approximately 6.8 mL/hour.

1. Poor personal hygiene

- Neglect: X

Rationale: Poor personal hygiene indicates neglect, as the caregiver is not providing adequate care for the client's basic needs.

2. Over sedation

- Physical abuse: X

Rationale: Over sedation is consistent with physical abuse because it involves administering medication to subdue the client, potentially to control or silence them.

3. Bruises in various stages of healing

- Physical abuse: X

Rationale: Bruises in various stages of healing are a sign of physical abuse, indicating that the client has been physically harmed multiple times over a period.

4. Depression or withdrawn behavior

- Mistreatment: X

Rationale: Depression or withdrawn behavior can be a result of mistreatment, which includes emotional and psychological abuse, leading to social isolation and emotional distress.

5. Untreated pressure injuries

- Neglect: X

Rationale: Untreated pressure injuries are a clear sign of neglect, as the caregiver is failing to provide necessary medical care to prevent and treat these injuries.

6. Leaving an older adult in a public space

- Mistreatment:

Rationale: Abandonment, which is a form of mistreatment, involves leaving the older adult in a public space without care or supervision.