The order is Ampicillin 1.5 grams added to 100mL of Normal Saline, infuse over 120 minutes. Drop Factor is 60gtt/mL. Available from pharmacy is Ampicillin 500mg in 10mL vial. Calculate the flow rate in gtt/min in which the IV fluid is to flow.

Anatomy: The bladder is a hollow, muscular organ located in the lower abdomen, just behind the pubic bone. It stores urine until it is emptied through urination. The area between the symphysis pubis (the joint where the two pubic bones meet) and the umbilicus (belly button) is directly over the bladder, making it the most appropriate place to palpate for bladder distention.

Signs of bladder distention: When the bladder is distended, it can be felt as a firm, round mass in the lower abdomen. The patient may also experience discomfort, pressure, or an urge to urinate.

Nursing assessment: Palpation is a key nursing assessment skill used to evaluate the size, shape, and position of organs within the abdomen. In this case, palpation helps the nurse to determine if the bladder is distended and to assess the severity of the distention.

Clinical significance: Bladder distention can occur for a variety of reasons, including:

Postoperative urinary retention due to anesthesia or pain medications

Urinary tract obstruction (e.g., from a kidney stone or enlarged prostate)

Neurological conditions that affect bladder function (e.g., spinal cord injury, multiple sclerosis)

Dehydration

Certain medications (e.g., diuretics, anticholinergics)

Prompt intervention: Bladder distention can lead to complications such as urinary tract infections, kidney damage, and discomfort. It's important for the nurse to identify and address bladder distention promptly to prevent these complications.

Choice A rationale:
Anticoagulant medications are the mainstay of treatment for thrombophlebitis. They work by preventing the formation of new blood clots and allowing the body's natural clot-dissolving mechanisms to break down existing clots. This helps to reduce the risk of the clot growing larger, breaking off, and traveling to the lungs (pulmonary embolism), which is a potentially life threatening complication.
Here is a detailed explanation of how anticoagulants work:
Blood clotting process: Blood clotting, also known as coagulation, is a complex process that involves multiple steps and factors. When a blood vessel is injured, a series of reactions occur to form a blood clot, which helps to stop bleeding.
Role of thrombin: Thrombin is a crucial enzyme in the clotting process. It converts fibrinogen, a soluble protein in the blood, into fibrin, which forms the mesh-like structure of blood clots.
Anticoagulants target thrombin: Anticoagulant medications work by inhibiting thrombin activity, thereby preventing the formation of fibrin and subsequent clot formation.
Different types of anticoagulants: There are several types of anticoagulant medications, each with different mechanisms of action. Some common types include:
Heparin: Heparin binds to antithrombin III, a natural anticoagulant in the body, and enhances its ability to inactivate thrombin and other clotting factors.
Warfarin: Warfarin blocks the production of vitamin K-dependent clotting factors in the liver.
Direct oral anticoagulants (DOACs): DOACs directly inhibit specific clotting factors, such as factor Xa or thrombin.
Choice B rationale:
Antibiotic medications are used to treat bacterial infections. Thrombophlebitis is not a bacterial infection, so antibiotics would not be effective in treating it.
Choice C rationale:
Antigen medications are not a category of medications. Antigens are substances that trigger an immune response in the body.
Choice D rationale:
Antihistamine medications are used to treat allergic reactions. They block the effects of histamine, a chemical released by the body during an allergic reaction. Antihistamines would not be effective in treating thrombophlebitis.