A client receives a prescription for dextrose 5% in water 500 mL IV to be infused over 4 hours. The IV administration set delivers 15 gtt/mL. How many gtt/min should the nurse regulate the infusion? (Enter numerical value only. If rounding is required, round to the nearest whole number.)

A) Sodium level 140 mEq/L (140 mmol/L):
The sodium level within the reference range does not indicate a vitamin D overdose. Sodium levels are typically not affected by vitamin D overdose.

B) Total calcium level 12 mg/dL (3 mmol/L):
This finding suggests a possible vitamin D overdose. Vitamin D plays a crucial role in calcium absorption from the intestines. Excessive vitamin D intake can lead to increased calcium absorption, resulting in hypercalcemia. Elevated calcium levels can lead to various symptoms such as nausea, vomiting, weakness, and confusion. Monitoring calcium levels is essential in individuals with suspected vitamin D overdose.

C) Total bilirubin 4 mg/dL (68.4 μmol/L):
Elevated bilirubin levels typically indicate liver dysfunction or hemolysis. It is not directly related to vitamin D overdose.

D) Serum glucose 170 mg/dL (9.4 mmol/L):
Elevated glucose levels suggest hyperglycemia, which can occur due to various factors such as diabetes mellitus or stress response. It is not directly related to vitamin D overdose.

A) Allow the client to take the medication up to 1 hour after breakfast:
Administering sucralfate up to 1 hour after breakfast may not provide optimal effectiveness as it should ideally be taken on an empty stomach to form a protective barrier over irritated areas in the stomach and intestines before food intake. Taking it after breakfast might not allow sufficient time for the medication to coat these areas adequately.

B) Instruct the client to take it when the meal tray is delivered:
Taking sucralfate with meals or when the meal tray is delivered is not recommended as food can interfere with its effectiveness. It is best taken on an empty stomach to allow it to coat the stomach lining without interference from food, ensuring maximum therapeutic benefit.

C) Document the client's refusal of the medication at this time:
Documenting a refusal should only be done if the client declines after receiving appropriate education and understanding. Simply refusing the client's request without providing education on the proper timing for taking sucralfate would not be appropriate.

D) Explain the need to take the medication at least 1 hour before meals:
This is the correct response. Educating the client about the importance of taking sucralfate at least 1 hour before meals ensures optimal effectiveness. This timing allows the medication to form a protective barrier over irritated areas in the stomach and intestines before food intake, maximizing its therapeutic benefit.