The healthcare provider prescribes magnesium sulfate 300 mg/hour IV. The IV bag is contains magnesium sulfate 4 grams in dextrose 5% in water (DW) 500 mL. How many mL/hour should the nurse set the infusion pump? (Enter numerical value only. If rounding is required, round to the nearest tenth.)

A) Apply a pulse oximeter to the client per protocol: The priority intervention is to monitor the client’s respiratory status closely when initiating a continuous epidural infusion with an opioid analgesic. Opioids can cause respiratory depression, and using a pulse oximeter helps in detecting any drop in oxygen saturation, allowing for timely intervention if respiratory issues arise.

B) Insert an indwelling urinary catheter per protocol: While an indwelling urinary catheter might be used in some cases for convenience and monitoring, it is not the immediate priority in the context of starting an epidural opioid infusion. The primary concern is monitoring for respiratory depression and ensuring the client’s safety with the opioid medication.

C) Administer an antiemetic per PRN prescription: Administering an antiemetic may be necessary if the client experiences nausea, which is a potential side effect of opioids. However, the more immediate concern when starting an opioid infusion is ensuring the client’s respiratory function is stable.

D) Administer a stool softener per PRN protocol: Stool softeners might be required to manage opioid-induced constipation, but this is not the most urgent concern when starting the medication. The immediate priority is monitoring respiratory status to prevent potential complications associated with opioid use.

A) Migraine headaches: While migraine headaches are significant for overall health management, they are less directly related to the risks associated with NSAID use compared to other conditions. Migraines do not typically influence the safety profile of NSAIDs.

B) Chronic alcoholism: Chronic alcoholism is a major concern because it significantly increases the risk of gastrointestinal complications with NSAID use. NSAIDs can cause gastric irritation, bleeding, and ulcers, and alcohol can exacerbate these risks, leading to severe gastrointestinal issues or liver damage.

C) Osteoarthritis: Osteoarthritis is a common indication for NSAID use and, therefore, does not pose an additional risk specific to the medication. NSAIDs are often prescribed to manage pain and inflammation associated with osteoarthritis.

D) Type 2 diabetes mellitus: Although diabetes mellitus requires careful management, it does not directly increase the risk of NSAID-related complications. However, clients with diabetes need to be monitored for overall health and medication effects, but chronic alcoholism poses a more immediate risk for NSAID use.