A nurse is preparing to administer clindamycin 300 mg by intermittent IV bolus over 30 min to a client who has a staphylococcal infection.
Available is clindamycin 900 mg in 50 mL. How many mL/hr should the nurse set the IV pump to? (Round to the nearest whole number, use a leading zero if it applies, do not use a trailing zero)

Choice A rationale:
A high-purine diet is not recommended for clients with gout. Purines are substances found in certain foods, such as red meat, organ meats, seafood, and beer. When the body breaks down purines, it produces uric acid. Uric acid is a waste product that can build up in the blood and cause gout attacks.
Choice B rationale:
Aspirin is not typically recommended for clients with gout. In fact, aspirin can sometimes worsen gout symptoms by increasing uric acid levels in the blood.
Choice C rationale:
Limiting alcohol intake is a key part of the treatment regimen for gout. Alcohol can increase uric acid levels in the blood and trigger gout attacks.
Choice D rationale:
Limiting fluid intake is not recommended for clients with gout. In fact, it is important for clients with gout to stay well- hydrated to help flush uric acid out of the body.

Choice A rationale:
Phenytoin is an anticonvulsant medication that is typically used long-term to control seizures. It is not a medication that can be stopped abruptly, as this can lead to the recurrence of seizures or even status epilepticus, a life-threatening condition characterized by continuous seizure activity.
The client's statement, "I'll be glad when I can stop taking this medicine," indicates a lack of understanding about the long- term nature of phenytoin therapy and the potential risks associated with stopping the medication prematurely.
Further teaching is needed to emphasize the importance of medication adherence and the potential consequences of non- adherence.

Choice B rationale:
Phenytoin can cause gingival hyperplasia (overgrowth of gum tissue), so it is important for clients taking this medication to see a dentist regularly for checkups and cleanings.
The client's statement, "I have made an appointment to see my dentist next week," indicates an understanding of this potential side effect and the need for regular dental care.

Choice C rationale:
Phenytoin has a narrow therapeutic index, meaning that there is a small difference between the effective dose and the toxic dose.
Switching brands of phenytoin can lead to changes in blood levels of the medication, which could potentially result in therapeutic failure or toxicity.
The client's statement, "I know that I cannot switch brands of this medication," indicates an understanding of this important safety consideration.

Choice D rationale:
Phenytoin can interact with many other medications, including over-the-counter medications and herbal supplements.
It is important for clients taking phenytoin to notify their doctor before taking any other medications to avoid potential drug interactions.
The client's statement, "I will notify my doctor before taking any other medications," indicates an understanding of this potential risk.