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A heparin infusion is prescribed for a client who weighs 220 pounds. After administering a bolus dose of 80 units/kg, the nurse calculates the infusion rate for the heparin solution at 18 units/kg/hour. The available solution is "Heparin Sodium 25,000 Units in 5% Dextrose Injection 250 mL". The nurse should program the infusion pump to deliver how many mL/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

Answer and Explanation

The Correct Answer is ["18"]

Calculation:

Convert the client's weight from pounds (lb) to kilograms (kg).

The client's weight is 220 lb.

Client weight (kg) = 220 lb/2.2 lb/kg

= 100 kg.

Calculate the total heparin dose to be administered per hour (units/hr).

The ordered rate is 18 units/kg/hour.

Total dose rate (units/hr) = 18 units/kg/hour×100 kg

= 1800 units/hr.

Determine the concentration of the available solution (units/mL).

Available solution is 25,000 units in 250 mL.

Concentration (units/mL) = 25,000 units/250 mL

= 100 units/mL.

Calculate the infusion rate in milliliters per hour (mL/hr).

Infusion rate (mL/hr) = Total dose rate (units/hr)/Concentration (units/mL)

= 1800 units/hr/100 units/mL

= 18 mL/hr.

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Free Nursing Study Resources

Correct Answer is ["A","B","C","D"]

Explanation

A. Nausea and vomiting: Gastrointestinal symptoms such as nausea, vomiting, and anorexia are common early signs of digoxin toxicity and should be closely monitored.

B. Fatigue and weakness: Generalized fatigue and muscle weakness can result from digoxin toxicity due to its effects on cardiac output and electrolyte imbalances, indicating early toxicity.

C. Bradycardia: Digoxin increases vagal tone, which can lead to bradycardia. A heart rate below 60 bpm is a key warning sign of digoxin toxicity.

D. Visual disturbances (e.g., yellow-green halos): Visual changes, including blurred vision, yellow-green halos, or altered color perception, are classic manifestations of digoxin toxicity and require prompt recognition.

E. Hypertension: Hypertension is not typically associated with digoxin toxicity; digoxin more commonly causes bradyarrhythmias and hypotension rather than elevated blood pressure.

A. Pasta with fish and an orange. B. Canned ham and green beans. C. Steak and baked potato with butter and cheese topping. D. Chicken, yams, pinto beans and pecans.

Correct Answer is A

Explanation

A. Pasta with fish and an orange: This is the best option because fish provides high-quality protein in moderation, pasta is low in potassium and phosphorus, and an orange provides vitamin C. While oranges contain potassium, a single serving can usually fit within dietary allowances if monitored.

B. Canned ham and green beans: Canned ham is high in sodium and phosphorus additives, both of which are harmful in CKD as they worsen fluid retention and bone-mineral imbalance.

C. Steak and baked potato with butter and cheese topping: Steak is a high-protein food that can increase uremic toxins, and baked potatoes are very high in potassium. The cheese topping adds extra phosphorus, making this meal unsafe for CKD clients.

D. Chicken, yams, pinto beans and pecans: While chicken is acceptable protein, yams and pinto beans are high in potassium, and pecans add excess phosphorus. This combination would increase the risk of electrolyte imbalance in CKD.

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Naxlex Comprehensive Predictor Exams

Patient Data Exhibits Which of the following findings should the nurse recognize as manifestations of digoxin toxicity? (Select all that apply.)

Correct Answer is ["A","B","C","D"]

Explanation

The nurse is caring for a client with chronic kidney disease (CKD). Which meal selection should the nurse recommend to the client?

Correct Answer is A

Explanation

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The nurse is assessing the body alignment of an immobilized client. Which is the best client position for the nurse to obtain an accurate assessment?

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Which oral medication can the nurse safely cut in half?

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