The nurse prepares a continuous aminophylline infusion at 0.3 mg/kg/hr for a client weighing 165 pounds.

The bag is mixed with 500 mg of aminophylline in 250 mL of D5W.

At which rate should the nurse set the pump in mL/hr? Round the answer to the tenths place.

Management of esophageal varices requires reducing the pressure gradient within the portal venous system. This scenario necessitates applying knowledge of splanchnic vasoconstriction and hemodynamic stability to prevent life-threatening hemorrhage and manage portal hypertension through pharmacological intervention and nursing surveillance.

Choice A rationale

Lactulose is a synthetic disaccharide that lowers blood ammonia levels by acidifying colonic contents and promoting excretion. While used in hepatic encephalopathy, it does not directly reduce portal hypertension or stop acute variceal bleeding.

Choice B rationale

Propranolol is a nonselective beta-blocker that reduces portal pressure by decreasing cardiac output and causing splanchnic vasoconstriction. It is the gold standard for preventing further variceal bleeding by lowering the hepatic venous pressure gradient.

Choice C rationale

Omeprazole is a proton pump inhibitor that reduces gastric acid secretion by inhibiting the hydrogen-potassium ATPase pump. While it prevents stress ulcers and treats gastritis, it has no direct hemodynamic effect on portal venous pressure.

Choice D rationale

Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the loop of Henle. It is used to manage ascites or edema but does not effectively target the portal hypertension causing varices.

Providing post-mortem care requires knowledge of legal requirements, hospital protocols, and psychosocial support. The nurse must apply principles of cultural sensitivity and respect for the deceased while ensuring that administrative and physical care tasks align with the specific circumstances of death.

Choice A rationale

While a physician or authorized practitioner must pronounce death and sign the certificate, it is not the immediate responsibility of the nurse to ensure the signature is completed before beginning initial post-mortem nursing care.

Choice B rationale

Removing tubes is often prohibited if an autopsy is required, especially in sudden or suspicious deaths. The nurse must first verify the cause of death and institutional policy before disturbing any medical devices or invasive lines.

Choice C rationale

Removing the body immediately is insensitive and may interfere with the grieving process. Families should be given adequate time to spend with the deceased to begin their emotional processing and perform any necessary rituals.

Choice D rationale

Allowing for religious and cultural customs is a core component of holistic nursing care. This respects the dignity of the deceased and supports the family's coping mechanisms during the immediate period following a significant loss.

Choice E rationale

Providing privacy is essential for the family to express grief without observation. This therapeutic environment allows for intimate goodbyes and facilitates the beginning of the mourning process in a respectful and safe hospital or hospice setting.