A client has been taking aspirin 325 mg six to eight times a day for the past two weeks to control pain from a knee injury.
Which symptom reported by the client should the nurse report to the health care provider (HCP) for priority follow-up?

Place the call bell in reach and respond promptly when activated.

This is a safety measure that allows the client to communicate their needs and request assistance when needed. The nurse should also check the drain for patency, observe for bright red bloody drainage, and maintain an aseptic technique when emptying the drain.

Choice A is wrong because advising the client to stay in bed and only get up with assistance may limit their mobility and increase the risk of complications such as deep vein thrombosis, pulmonary embolism, or pneumonia.

The client should be encouraged to ambulate as soon as possible after surgery, with appropriate assistance and precautions.

Choice C is wrong because maintaining the bed at working height for convenience when doing post-op vital signs may increase the risk of falls or injury if the client tries to get out of bed without assistance.

The bed should be lowered to a safe position and locked when not in use.

Choice D is wrong because keeping the lights off to encourage the client to rest and recuperate may impair the client’s vision and orientation, and increase the risk of falls or injury if they try to get out of bed without assistance.

The client should have adequate lighting in their room and be oriented to their surroundings.

Choice E is wrong because attaching the drain to wall suction and keeping the tubing pinned to the client’s gown may interfere with the function of the drain and cause tension or kinking of the tubing. The drain should be attached to gravity drainage and secured loosely to prevent accidental dislodgment.

To explain why, we need to use the formula for calculating the drip rate in drops per minute (dpm):

Volume of IV fluid (mL) x Drop Factor (drops/mL) / Time to run (h) x 60 (min/h) = Drip Rate (dpm)

In this question, the volume of IV fluid is one liter, which is equivalent to 1000 mL. The drop factor is 15 drops per mL, as given by the tubing.

The time to run is six hours, as ordered by the physician. Plugging these values into the formula, we get:

1000 mL x 15 drops/mL / 6 h x 60 min/h = 84 dpm

Therefore, the nurse should regulate the infusion to deliver 84 drops per minute.

Choice A is wrong because it gives a drip rate of 42 drops per minute, which is half of the correct answer.

This would result in delivering only 500 mL of normal saline in six hours, instead of one liter.

Choice C is wrong because it gives a drip rate of 100 drops per minute, which is more than the correct answer.

This would result in delivering 1.43 liters of normal saline in six hours, instead of one liter.

Choice D is wrong because it gives a drip rate of 166 drops per minute, which is almost double the correct answer.

This would result in delivering 1.99 liters of normal saline in six hours, instead of one liter.

Normal saline is a solution of 0.9% sodium chloride in water, which has the same osmolarity as blood plasma.

It is used to treat dehydration, shock, blood loss, and other conditions that require fluid replacement.

The normal range of sodium in blood is 135-145 mEq/L.