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)Holds the pen in place after the injection:
This action is appropriate. Holding the auto-injector pen in place after administering the injection allows the medication to be fully delivered into the muscle. It ensures that the full dose of epinephrine is administered, which is crucial during an emergency situation such as anaphylaxis.

B) Administers into the fleshy outer thigh:
Administering the epinephrine injection into the fleshy outer thigh is the correct technique. The thigh muscle provides a large and accessible area for injection, allowing for rapid absorption of the medication into the bloodstream. This action facilitates the quick onset of epinephrine’s effects, which is vital in treating anaphylaxis.

C) Cleanses the injection pen for re-use:
This action requires intervention by the nurse. Epinephrine auto-injectors are designed for single use only and should not be cleansed or reused. Reusing the injection pen can lead to contamination, incorrect dosing, or malfunction, compromising its effectiveness during subsequent emergencies. It is essential to educate the client that the auto-injector pen is for one-time use only, and a new device should be used if another dose is required.

D) Inserts the injection pen through clothing:
While it is ideal to administer the injection directly onto bare skin, inserting the injection pen through clothing is acceptable in emergency situations when immediate access to bare skin is not possible. The priority during anaphylaxis is administering the epinephrine promptly. However, if feasible, the clothing should be moved aside to allow direct contact of the injection site with the skin for optimal absorption of the medication.

A) Urinary output equal intake:
This assessment finding suggests that the client is voiding an amount of urine equivalent to their fluid intake, indicating effective bladder emptying. Bethanechol is a cholinergic agonist that stimulates bladder contraction, helping to improve urinary retention by promoting the expulsion of urine from the bladder. Equal urinary output and intake indicate that the bladder is adequately emptying, which is a positive response to bethanechol therapy.

B) No terminal urinary dribbling:
While the absence of terminal urinary dribbling may be an indicator of improved bladder emptying, it is not as definitive as assessing urinary output equal to intake. Terminal urinary dribbling refers to the involuntary loss of urine that occurs after completing urination due to incomplete emptying of the bladder. While its absence may suggest improved bladder emptying, it is not as reliable an indicator as measuring urinary output.

C) Denies stress incontinence:
The absence of stress incontinence, which is the involuntary loss of urine during activities that increase intra-abdominal pressure (such as coughing, sneezing, or lifting), is not directly related to the effectiveness of bethanechol for urinary retention. Bethanechol primarily targets urinary retention by stimulating bladder contraction rather than addressing stress incontinence, which involves weakness of the pelvic floor muscles.

D) Absence of xerostomia:
Xerostomia refers to dryness of the mouth due to decreased saliva production and is a common side effect of anticholinergic medications. Bethanechol, as a cholinergic agonist, may actually increase saliva production and is not typically associated with xerostomia. However, the absence of xerostomia does not directly indicate the effectiveness of bethanechol for urinary retention.