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The nurse mixes diphenhydramine 25 mg in a 100 mL bag of 0.9% sodium chloride, which is to be administered IV over 30 minutes. The IV pump should be set to administer how many mL/hour? (Enter numeric value only.)

Answer and Explanation

The Correct Answer is ["200"]

Identify the total volume to be infused.

Total volume = 100 mL

Identify the infusion time in minutes.

Infusion time = 30 minutes

Convert the infusion time to hours.

Infusion time (hours) = Infusion time (minutes) / 60 minutes/hour

= 30 minutes / 60 minutes/hour

= 0.5 hours

Calculate the infusion rate in mL per hour.

Infusion rate (mL/hour) = Total volume (mL) / Infusion time (hours)

= 100 mL / 0.5 hours

= 200 mL/hour

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Correct Answer is A

Explanation

A. Hearing has decreased: Gentamicin is an aminoglycoside antibiotic known for its potential to cause ototoxicity, leading to hearing loss, tinnitus, or balance disturbances. Early signs of auditory damage, such as decreased hearing, must be promptly recognized because ototoxicity can be irreversible if the drug is not discontinued or adjusted quickly.

B. White blood cell count of 6,000/mm³ (6 × 10⁹/L): A WBC count within the range of 5,000 to 10,000/mm³ is considered normal. A value of 6,000/mm³ does not suggest bone marrow suppression or infection-related complications and is not an indicator of gentamicin toxicity.

C. Decreased blood urea nitrogen: Gentamicin is more commonly associated with nephrotoxicity, which typically leads to increased BUN and creatinine levels due to kidney injury. A decreased BUN level would not suggest an adverse reaction to gentamicin and would not be expected.

D. Reports of photophobia: Photophobia is not a recognized adverse effect of gentamicin. Visual disturbances like photophobia are more commonly associated with other medications or conditions, not aminoglycoside toxicity.

A. Hold the dose and notify the healthcare provider (HCP) of the changes in the laboratory studies. B. Hold the dose and notify the pharmacy to stop dispersing the next premixed doses. C. Begin the infusion and submit a drug reaction report to the nursing supervisor. D. Begin the infusion and monitor the client's blood urea nitrogen (BUN), serum creatinine, and liver function tests.

Correct Answer is A

Explanation

A. Hold the dose and notify the healthcare provider (HCP) of the changes in the laboratory studies: Fluconazole is hepatotoxic and can cause elevations in liver enzymes, including AST. A rising trend in liver enzymes suggests possible liver injury, and administering another dose without medical clearance could worsen hepatic damage. Immediate communication with the HCP is the safest and most appropriate action.

B. Hold the dose and notify the pharmacy to stop dispersing the next premixed doses: Although stopping further dispensing may eventually be needed if the drug is discontinued, the pharmacy cannot make this clinical decision. Notifying the HCP for evaluation and new orders must take priority.

C. Begin the infusion and submit a drug reaction report to the nursing supervisor: Initiating the infusion despite abnormal liver function tests can endanger the client. Reporting an adverse reaction to the supervisor is important after ensuring the client’s safety, but the infusion should be held first pending provider instructions.

D. Begin the infusion and monitor the client's blood urea nitrogen (BUN), serum creatinine, and liver function tests: While monitoring labs is critical during fluconazole therapy, starting the infusion in the presence of worsening liver enzyme trends without provider approval can increase the risk of serious hepatic complications.

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The nurse mixes diphenhydramine 25 mg in a 100 mL bag of 0.9% sodium chloride, which is to be administered IV over 30 minutes. The IV pump should be set to administer how many mL/hour? (Enter numeric value only.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A male client has been receiving the antibiotic gentamicin sulfate, IV piggyback every 12 hours for several days. Which observation by the nurse indicates that the client may be experiencing an adverse effect of gentamicin? Reference Range: White Blood Cell [5,000 to 10,000/mm3 (5 to 10 10^9/L)]

Correct Answer is A

Explanation

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

Correct Answer is A

Explanation

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The nurse mixes diphenhydramine 25 mg in a 100 mL bag of 0.9% sodium chloride, which is to be administered IV over 30 minutes. The IV pump should be set to administer how many mL/hour? (Enter numeric value only.)