The healthcare provider prescribes the antibiotic surgical prophylaxis protocol for a client who weighs 90 kg. The protocol is cefazolin 2 grams/100 mL. 0.9% normal saline over 1 hour for clients weighing less than 285.5 pounds or cefazolin 3 grams/100 mL 0.9% normal saline over 90 minutes for clients weighing greater than 265.5 pounds. The nurse should program the pump to deliver how many mL/hr? (Enter number value only. If rounding is required, round to the nearest whole number.)

Answer and Explanation

The Correct Answer is ["100"]

Since the client weighs 90 kg, let’s first convert their weight to pounds to determine the appropriate cefazolin dosage:

Conversion factor: 1 kg = 2.205 pounds

Client weight (pounds) = 90 kg x 2.205 pounds/kg = 198.45 pounds (rounded to two decimals)

Now, comparing the client’s weight (198.45 pounds) to the weight threshold (265.5 pounds):

Client weight is less than the threshold (198.45 pounds < 265.5 pounds).

Therefore, the appropriate dosage is:

Cefazolin 2 grams/100 mL 0.9% normal saline over 1 hour.

The pump rate is determined by the total volume of the IV fluid and the infusion time.

We are not given the specific bag size, but typically these come in 100 mL or 500 mL volumes.

Assuming a 100 mL bag (which aligns with the concentration provided):

Total volume of IV bag: 100 mL

Infusion time: 1 hour

Calculation:

Pump rate (mL/hr) = Total volume (mL) / Infusion time (hr)

Pump rate (mL/hr) = 100 mL / 1 hour = 100 mL/hr

Therefore, the nurse should program the pump to deliver 100 mL/hr.

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Correct Answer is C

Explanation

A) Tamsulosin is typically administered once daily, not on a twice-weekly dosing schedule. Instructing the client to adhere to the prescribed dosing frequency is essential for maintaining therapeutic blood levels of the medication and optimizing its effectiveness in managing urinary retention associated with benign prostatic hyperplasia (BPH).

B) While the timing of medication administration can impact its effectiveness, taking tamsulosin early in the day versus later in the day may not significantly affect its therapeutic action. The key consideration with tamsulosin is to maintain consistency in timing to ensure a steady plasma concentration of the drug.

C) Instructing the client to stand and sit up slowly is crucial because tamsulosin, as an alpha-blocker, can cause orthostatic hypotension, especially when first starting the medication or when increasing the dosage. By advising the client to change positions slowly, the nurse helps prevent falls and dizziness, which are common side effects associated with sudden drops in blood pressure.

D) Reducing daily fluid intake is not advisable, especially for a client with urinary retention. Maintaining adequate hydration is essential for overall health and urinary function. Tamsulosin works by relaxing the smooth muscles of the prostate and bladder neck, facilitating urine flow, but it does not directly affect fluid intake requirements.

Therefore, the most important instruction for the nurse to provide is to stand and sit up slowly to minimize the risk of orthostatic hypotension and associated complications.

A. pH. B. Calcium. C. Potassium. D. Phosphate.

Correct Answer is D

Explanation

pH: Calcium acetate is not directly related to changes in blood pH. Therefore, monitoring pH levels would not indicate the effectiveness of the medication for CKD.

B) Calcium: Calcium levels may be affected by calcium acetate, but the primary goal of using calcium acetate in CKD is to reduce phosphate levels, not calcium levels. Therefore, monitoring calcium levels would not directly indicate the effectiveness of the medication.

C) Potassium: Calcium acetate is not typically used to affect potassium levels. Monitoring potassium levels would not indicate the effectiveness of calcium acetate for CKD.

D) Phosphate: This is the correct answer. Calcium acetate is a phosphate binder commonly used in CKD to help lower elevated phosphate levels. A decrease in phosphate levels in the blood would indicate that the medication is having the desired effect in controlling phosphate levels, which is important in managing CKD and preventing complications associated with hyperphosphatemia. Therefore, monitoring phosphate levels is essential to assess the effectiveness of calcium acetate therapy in CKD.

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Naxlex Comprehensive Predictor Exams

A client is receiving tamsulosin for the management of urinary retention due to benign prostatic hyperplasia (BPH), Which instruction is most important for the nurse to provide?

Correct Answer is C

Explanation

A client with chronic kidney disease (CKD) is receiving calcium acetate 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?

Correct Answer is D

Explanation

The nurse is administering IV fluconazole to a client who has systemic candidiasis. After reviewing the client's di’gnostic studies, the nurse identifies a rising trend in the liver enzyme levels for aspartate aminotransferase (AST). Which action should the nurse implement?

The nurse is providing discharge instructions for a client with metastatic cancer who is proscribed morphine for bone pain. Which information from the client indicates to the nurse an understanding of the medication?

A client with myasthenia gravis receives a now prescription for pyridostigmine. Which information should the nurse obtain to prior to administering the medication?

Before administering the initial dose of sumatriptan succinate to a client with a migraine headache, it is most important to determine if the client's hi’tory includes which problem?

A young adult female client who is planning to become pregnant asks the nurse if she can continue taking isotretinoin for cystic acne. Which information is most important for the nurse to provide this client?

A female client with osteoporosis has been taking a weekly dose of oral risedronate for several weeks. The client calls the clinic nurse to report increasing “heartburn.” How should the nurse respond?