A nurse is planning care for a patient who requires screening for rectal cancer. Which of the following tests should the nurse anticipate in the patient’s plan of care?

Step 1 is to understand the question. The patient has been prescribed vancomycin 1 g in 250 mL dextrose 5% (D5W) to be administered over 2 hours via IV intermittent bolus. We need to calculate how many mL/hr the nurse should set the IV pump to deliver.

Step 2 is to calculate the rate. The total volume to be administered is 250 mL and the time for administration is 2 hours. So, the rate is 250 mL ÷ 2 hours = 125 mL/hr.

Choice A rationale

0.9% sodium chloride, also known as normal saline, is an isotonic solution that is commonly used for hydration and to replace lost fluids. However, it does not provide any calories or nutrients, which are necessary for patients receiving TPN1.

Choice B rationale

Dextrose 10% in water (D10W) is the recommended solution to administer until the next TPN solution is available. This is a hypertonic fluid that provides dextrose to the patient, helping to maintain their blood glucose levels and reducing the risk of hypoglycemia.

Choice C rationale

3% sodium chloride is a hypertonic saline solution that is typically used to treat patients with severe hyponatremia (low sodium levels). It is not suitable as a replacement for TPN as it does not provide the necessary nutrients and can lead to hypernatremia (high sodium levels) if used inappropriately.

Choice D rationale

Lactated Ringer’s solution is an isotonic solution that is commonly used for fluid resuscitation in patients with significant fluid loss. While it does contain multiple electrolytes that mimic those found in plasma, it does not provide any calories or nutrients, making it unsuitable as a replacement for TPN1.