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A physician orders normal saline for a client to replace lost fluids due to poor oral intake. The order is for 1000 mL D5W to be infused over a period of 4 hours. If the drop factor is 5 drops/mL, the nurse would determine the IV flow rate to be
- A. 20 drops/min
- B. 21 drops/min
- C. 22 drops/min
- D. 23 drops/min
Correct Answer: B
Rationale: 1000 mL / 4 hours = 250 mL/hr; 250 mL/hr ? 1 hr/60 min = 4.17 mL/min; 4.17 mL/min ? 5 = 20.8 or 21 drops/min.
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A nurse is assigned to care for a client who has received albumin intravenously. The nurse understands that which of the following reasons has prompted the administration of plasma protein fractions to the client?
- A. The client must have lost a lot of blood volume due to severe hemorrhage.
- B. The client must have poor wound-healing abilities with a high risk of infection.
- C. The client must be experiencing a condition in which plasma alone is lost.
- D. The client must be experiencing hypovolemic shock due to trauma.
Correct Answer: D
Rationale: Plasma protein fractions are used in clients to treat hypovolemic shock that occurs as a result of burns, trauma, surgery, and infections or in conditions where shock is not currently present but likely to occur. It is also used in the case of hypoproteinemia, as might be seen in clients with nephrotic syndrome and hepatic cirrhosis, as well as other diseases or disorders.
The use of an infusion pump or controller still requires nursing supervision and frequent monitoring of the IV infusion to monitor for signs of infiltration. Assessment of which of the following at the infusion site would lead the nurse to suspect that infiltration is occurring? Select all that apply.
- A. Edema
- B. Necrosis
- C. Burning
- D. Itching
- E. Redness
Correct Answer: A,E
Rationale: It is important for the nurse to monitor frequently for signs of infiltration while an infusion pump is in use. The signs of infiltration include edema and redness at the infusion site.
A client is at risk for hypercalcemic syndrome. The primary health care provider prescribes additional therapy to combat this syndrome. Which of the following would the nurse expect to be prescribed? Select all that apply.
- A. Sodium chloride
- B. Potassium
- C. Furosemide
- D. Magnesium
- E. Bicarbonate
Correct Answer: A,C
Rationale: To combat hypercalcemic syndrome, the primary health care provider may prescribe IV sodium chloride and a potent diuretic such as furosemide. When used together, these two drugs markedly increase calcium renal clearance and reduce hypercalcemia.
A nurse is administering IV fluid and electrolyte therapy to a client. The nurse reviews the client's laboratory test results. Which result would the nurse immediately report to the primary health care provider?
- A. Calcium 4.7 mEq/L
- B. Magnesium 2.0 mEq/L
- C. Potassium 2.1 mEq/L
- D. Sodium 140 mEq/L
Correct Answer: C
Rationale: The nurse would report a potassium level of 2.1 mEq/L because this indicates hypokalemia. A calcium level of 4.7 mEq/L, magnesium level of 2.0 mEq/L, and sodium level of 140 mEq/L are within normal ranges.
A physician orders levofloxacin (Levaquin) for a client to treat infection. The order is for levofloxacin (Levaquin) 500 mg/100 mL to be infused over a period of 1 hour. The IV infusion set has a drop factor of 10 drops/mL. The nurse would set the infusion flow rate at
- A. 16 drops/min
- B. 17 drops/min
- C. 18 drops/min
- D. 19 drops/min
Correct Answer: B
Rationale: 100 mL / 1 hour = 100 mL/hr; 100 mL/hr ? 1 hr/60 min = 1.67 mL/min; 1.67 mL/min ? 10 = 16.7 or 17 drops/min.