The client is prescribed pantoprazole 8 mg/hr after a bolus dose is given. The standard concentration from the pharmacy is 80 mg in 200 mL. How many hours will one bag take to infuse? (Use a leading zero if it applies. Do not use a trailing zero. Round to the nearest hour.)

A. is experiencing a respiratory infection and is short of breath: While a respiratory infection and shortness of breath can exacerbate symptoms of Myasthenia Gravis (MG), this condition does not specifically increase the risk of a cholinergic crisis. However, respiratory issues can worsen during a crisis, but they are not the main trigger.

B. reports taking a daily extra dose of their anticholinesterase medication: Cholinergic crisis occurs when there is an overdose of anticholinesterase medication, which increases acetylcholine levels and causes overstimulation of the parasympathetic nervous system. Symptoms include excessive salivation, sweating, diarrhea, bradycardia, and respiratory distress. Taking an extra dose of anticholinesterase medication can lead to this crisis, making the patient most at risk in this scenario.

C. has a family history of autoimmune disorders: While a family history of autoimmune disorders might indicate a predisposition to developing autoimmune conditions, it does not directly increase the risk of a cholinergic crisis. Cholinergic crises are more specifically related to medication dosing in MG.

D. has a past medical history of type 2 diabetes mellitus: Type 2 diabetes mellitus does not have a direct correlation with an increased risk of developing a cholinergic crisis in a patient with MG. The risk of cholinergic crisis is more related to the administration of anticholinesterase medications, not diabetes.

A. The client will be turned every 2 hours is a general nursing care practice for all immobile clients to prevent pressure injuries, but it is not specific to the protocol surrounding the use of restraints.

B. The client will need to be monitored every one-half hour is incorrect because clients in restraints must be monitored more frequently—typically every 15 minutes, depending on facility policy and client condition, to assess circulation, skin integrity, and psychological well-being.

C. Documentation of the event will include interventions attempted prior to initiating restraints is the correct answer. Before applying restraints, it is a legal and ethical requirement to document all less restrictive interventions that were attempted and found ineffective. This ensures that restraints are used only as a last resort and that the client's rights and safety are protected.

D. The physician must be present at the time of the restraint episode is incorrect. While a physician's order is required for restraint use, the physician does not need to be physically present at the time of application. However, the physician must conduct a face-to-face evaluation within a specific timeframe, usually within 1 hour of the restraint being applied, depending on regulatory guidelines.