Zyvox 600 mg IV once a day is ordered for a patient. The Zyvox is dissolved in 300 mL of normal saline and should infuse over 1 hour. Using tubing with a drop factor of 10 gtt/mL, how many drops per minute should the Zyvox be infused?

Choice A reason: Positioning with hips flexed at 90 degrees is inappropriate for Buck’s traction, which is a skin traction applied to the lower leg to align fractures. Excessive hip flexion can disrupt traction alignment and increase discomfort or complications.
Choice B reason: Weights in Buck’s traction must hang freely to maintain constant force for fracture alignment. Contact with the floor negates the traction’s effect, risking bone misalignment and delayed healing, making this an incorrect care practice.
Choice C reason: Checking for skin irritation is critical in Buck’s traction, as prolonged pressure from straps or bandages can cause pressure ulcers or skin breakdown. Regular skin assessment ensures early detection and prevention of complications, maintaining the traction’s safety and efficacy.
Choice D reason: Releasing weights disrupts the continuous force needed for fracture alignment in Buck’s traction. This can lead to bone displacement, increased pain, or delayed healing, making scheduled weight release an inappropriate and harmful practice.

Choice A reason: The maximum daily dose of acetaminophen for adults is typically 4000 mg to avoid hepatotoxicity. A statement indicating 5000 mg suggests a misunderstanding, as exceeding 4000 mg increases the risk of liver damage due to the accumulation of toxic metabolites like N-acetyl-p-benzoquinone imine, which depletes glutathione.
Choice B reason: Regular liver function tests are recommended for clients on long-term acetaminophen to monitor for hepatotoxicity, as the drug is metabolized by the liver. This statement shows correct understanding, as it acknowledges the need to assess liver enzymes like ALT and AST for potential damage.
Choice C reason: Checking other medications for acetaminophen content is crucial to prevent unintentional overdose, which can lead to acute liver failure. This statement reflects proper understanding, as combination drugs (e.g., cold remedies) often contain acetaminophen, contributing to cumulative toxicity if not monitored.
Choice D reason: Using topical patches or creams for osteoarthritis pain is a valid adjunctive therapy. These deliver localized relief (e.g., NSAIDs or capsaicin) without systemic effects, complementing acetaminophen’s action. This statement indicates correct understanding of multimodal pain management strategies.