The nurse is about to administer 1 liter (1000 mL) of 0.9% NS over 2 hours intravenously to a patient in shock.

What rate should the nurse set on the infusion pump?

Choice A rationale
Discussing facility policies with coworkers. While understanding facility policies is important, it does not necessarily contribute to maintaining clinical competence.
Choice B rationale
Attending a professional conference. This is the correct answer. Professional conferences often provide opportunities for continuing education, learning about the latest research and best practices, and networking with other professionals in the field.
Choice C rationale
Joining a nurses’ union. While a union can provide support and advocacy for nurses, joining a union does not directly maintain clinical competence.
Choice D rationale
Removing expired supplies from the storage area. This is an important task for maintaining a safe and effective work environment, but it does not contribute to maintaining clinical competence.

Based on the provided exhibits, the client is most likely experiencingBacterial Meningitis. This is indicated by symptoms such as severe headache, fever, sensitivity to light, nuchal rigidity, and the presence of Neisseria meningitidis in the cerebrospinal fluid with elevated white blood cell count and lactic acid levels.

The two actions the nurse should take to address this condition are:

1. Anticipate administering antibiotic therapy- This is crucial as the client’s culture and sensitivity test indicates the presence of Neisseria meningitidis, which requires antibiotic treatment.
2. Place the client on droplet precautions- Since Neisseria meningitidis can be spread through respiratory droplets, it is important to implement droplet precautions to prevent the spread of infection.

The two parameters the nurse should monitor to assess the client’s progress are:

1. Level of consciousness- Monitoring for changes in the client’s level of consciousness can indicate the effectiveness of the treatment and the progression of the disease.
2. Increased intracranial pressure- Signs of increased intracranial pressure can include changes in vital signs, level of consciousness, and the presence of headache or vomiting. Monitoring these signs is important in the management of bacterial meningitis.