A nurse is inserting an IV catheter for an older client in preparation for an outpatient procedure. Which of the following veins should the nurse select?

A. Stop the enema and document that the client did not tolerate the procedure:
This option may be appropriate if the client's discomfort is severe or if there are signs of distress. However, abdominal cramps are a common sensation during the administration of an enema, especially if the bowel is distended or constipated. Therefore, stopping the procedure may not be necessary at this point.
B. Encourage the client to bear down:
Bearing down might help the client expel the enema solution and relieve some discomfort. However, if the client is already experiencing abdominal cramps, bearing down could exacerbate the discomfort and is not likely to provide immediate relief.
C. Lower the height of the solution container:
This is the correct action to take. Lowering the height of the solution container reduces the flow rate of the enema solution, which can help alleviate abdominal cramps by slowing the rate of distension of the bowel. Slowing the infusion rate allows the client's colon to accommodate to the enema more comfortably.
D. Allow the client to expel some fluid before continuing:
Allowing the client to expel some fluid before continuing may provide some relief, but it does not directly address the cause of the discomfort. Lowering the height of the solution container is a more appropriate action to address the discomfort caused by abdominal cramps during the administration of the enema.

A. CD4 T cell count 180 cells/mm3: In a client with HIV, monitoring the CD4 T cell count is crucial for assessing immune function and determining the progression of the disease. A CD4 T cell count of less than 200 cells/mm3 indicates severe immunosuppression and an increased risk of opportunistic infections, making it the priority laboratory value to monitor in this client.
B. Platelets 150,000/mm3: While platelet count is important for assessing clotting function, it is not the priority laboratory value in a client with HIV. Thrombocytopenia can occur in HIV but is often secondary to other factors such as medication side effects or opportunistic infections. However, a platelet count within the normal range of 150,000/mm3 is reassuring and does not require immediate intervention.
C. WBC 5000 mm3: White blood cell (WBC) count is essential for assessing overall immune function, but it is not the priority laboratory value in a client with HIV. A WBC count of 5000 mm3 is within the normal range and does not require urgent attention.
D. Positive Western blot test: While a positive Western blot test confirms HIV infection, it does not provide information about the client's current immune status or the need for immediate intervention. Confirmatory tests such as Western blot are important for diagnosis, but they do not provide ongoing monitoring of disease progression or immune function.