The nurse prepares to administer a dopamine infusion at 4 mcg/kg/min for a client weighing 165 pounds. The nurse has a dopamine solution with a concentration of 400 mg in 250 mL of 5% dextrose. The nurse should set the IV pump to how many millimeters per hour? Round to the nearest tenth.

Rationale:

A. Applying moisturizer is a non-invasive, routine hygiene measure that falls within the scope of practice of unlicensed assistive personnel (UAP). It helps relieve pruritus by reducing skin dryness and can be safely delegated.

B. This is incorrect because applying prescription medications requires nursing judgment and knowledge of the medication, dose, and timing. This task must be performed by a licensed nurse.

C. This is incorrect because increasing room temperature may actually worsen pruritus, as heat can aggravate itching. Additionally, adjusting environmental controls for therapeutic purposes is part of the nurse’s assessment and planning, not a delegated task.

D. This is incorrect because hot baths can worsen pruritus and damage already sensitive skin. Bathing interventions should be guided by the nurse to ensure safety and appropriate temperature and products are used.

Rationale:

A. After a paracentesis, it is normal for a small amount of clear serous fluid to appear at the puncture site. This finding is expected and typically resolves on its own. It does not indicate a complication such as infection or significant bleeding, as long as the drainage remains minimal and there are no other abnormal signs like redness, swelling, or purulent discharge. Therefore, it is not an immediate concern.

B. These vital signs indicate hypotension and compensatory tachycardia, which are concerning for post-paracentesis circulatory compromise. Large-volume paracentesis, such as removing 2,000 mL of ascitic fluid, can lead to rapid shifts in intravascular fluid volume, resulting in decreased circulating blood volume, hypotension, and potential hypovolemic shock. These signs are life-threatening and require immediate action, including close monitoring, intravenous fluid replacement, and notification of the healthcare provider. This is the priority over other findings because hemodynamic instability poses the most immediate risk to the client’s survival.

C. Emotional distress is important and requires supportive care, but it does not constitute an immediate physiological threat. While addressing the client’s anxiety and providing psychological support is essential, it is secondary to stabilizing vital signs and ensuring circulatory adequacy.

D. Weight loss after paracentesis is an expected outcome because the fluid removed contributes to body weight. This finding reflects the therapeutic effect of the procedure and is not a sign of complication.