A nurse is assessing a clie”t prior to administering atenolol. Which of the following findings should prompt the nurse to withhold the medication?

We are given the following information:

Medication: Ticarcillin/clavulanate 3.1 g

Administration route: Intermittent IV bolus over 30 minutes

Available solution: Ticarcillin/clavulanate 3.1 g in 50 mL 0.9% sodium chloride (NSS)

However, the IV pump controls the rate of delivery over time (usually in hours). An intermittent bolus means the medication is infused all at once over a shorter period (30 minutes in this case).

The pump rate calculation here focuses on the total volume of the available solution containing the medication to be delivered, not necessarily on the medication amount itself.

Therefore, we need to find the rate at which the total volume of 50 mL solution should be delivered over 30 minutes.

Conversion is necessary because pump rates are typically set in hours (hr).

Time (hours) = 30 minutes / 60 minutes/hour = 0.5 hours

Now, calculate the flow rate:

Flow rate (mL/hr) = Total volume (mL) / Infusion time (hours)

Flow rate (mL/hr) = 50 mL / 0.5 hours = 100 mL/hr

Round to the nearest whole number as requested.

Therefore, the nurse should set the pump to deliver approximately 100 mL/hr. This ensures the total 50 mL solution containing the 3.1 g of ticarcillin/clavulanate is delivered over the intended 30-minute period.

A) Loss of protective respiratory mechanisms due to prolonged irritation or damage:
Individuals with COPD often experience a progressive loss of protective respiratory mechanisms over time. Chronic exposure to irritants such as cigarette smoke leads to inflammation, structural changes in the airways, and destruction of lung tissue, impairing the body's ability to clear mucus, trap foreign particles, and maintain normal lung function. This loss of protective mechanisms contributes to the hallmark symptoms of COPD, including airflow limitation, chronic cough, and increased susceptibility to respiratory infections.

B) Localized swelling and inflammation within the lungs:
While inflammation is a hallmark feature of COPD, it typically manifests as widespread inflammation throughout the lungs rather than localized swelling. In COPD, chronic exposure to irritants leads to a systemic inflammatory response that affects the entire respiratory tract, including the bronchi and alveoli. This inflammation contributes to airway obstruction, mucus hypersecretion, and the development of respiratory symptoms.

C) An acute viral infection of the respiratory tract:
While individuals with COPD are at increased risk of respiratory infections, including viral infections such as influenza and respiratory syncytial virus (RSV), COPD itself is a chronic, progressive respiratory condition characterized by persistent airflow limitation. Acute viral infections may exacerbate COPD symptoms and lead to worsening respiratory function, but they are not inherent features of the disease itself.

D) Inflammation and swelling of the sinus membranes over a prolonged period:
Sinus inflammation and swelling, known as sinusitis, are not typically considered primary features of COPD. While individuals with COPD may experience comorbid conditions such as chronic rhinosinusitis, which can contribute to respiratory symptoms and exacerbations, sinus inflammation is not a defining characteristic of the disease.