The prescription is for Ampicillin 1.5 grams to be added to 100mL of Normal Saline, to be infused over 120 minutes. The Drop Factor is 60gtt/mL. The pharmacy has provided Ampicillin 500mg in a 10mL vial. Calculate the flow rate in gtt/min at which the IV fluid should flow.
(Consider the medication that must be added to the total volume of fluid)

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:
Sims' position is a side-lying position with the lower leg flexed and the upper leg extended. It is not ideal for bladder scanning because it can compress the bladder and make it difficult to obtain an accurate reading.
Additionally, in Sims' position, the bladder may not be fully accessible to the scanner, as it may be partially obscured by the upper thigh.
Choice B rationale:
Dorsal recumbent position is the optimal position for bladder scanning. In this position, the client lies flat on their back with their knees bent and their feet flat on the bed. This position allows for:
Full exposure of the bladder, making it easily accessible to the scanner.
Relaxation of the abdominal muscles, which can help to ensure an accurate reading.
A comfortable position for the client, promoting cooperation and reducing the likelihood of movement that could interfere with the scan.

Choice C rationale:
Supine position is a similar position to dorsal recumbent, but with the legs fully extended. While it is possible to perform a bladder scan in this position, it is not as ideal as dorsal recumbent because:
The extended legs can place some tension on the abdominal muscles, potentially affecting bladder position and the scan's accuracy.
The client may find this position less comfortable, leading to restlessness and potential movement that could interfere with the scan.

Choice D rationale:
High Fowler's position is a semi-sitting position with the head of the bed elevated at a 45- to 60-degree angle. This position is not suitable for bladder scanning because:
Gravity can pull the bladder downwards, making it difficult to visualize and measure accurately.
It can be challenging to maintain proper positioning of the scanner on the abdomen in this position, potentially leading to inaccurate readings.