A nurse is preparing to administer clindamycin by intermittent IV bolus over 30 minutes to a client who has a staphylococcal infection. Available is 300 mg clindamycin premixed in 50 mL 0.9% sodium chloride (NaCl). The nurse should set the IV pump to deliver how many mL/hr?

(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Choice A reason:

Calling the lab to verify the client’s results is a reasonable step if there is any doubt about the accuracy of the lab results. However, in this scenario, the potassium level of 5.2 mEq/L is already documented, and the nurse should act on this information. Verifying the results would delay necessary actions and could potentially harm the patient if the high potassium level is not addressed promptly.

Choice B reason:

Omitting the KCL dose and documenting it as not given is a prudent action because administering potassium chloride to a patient with an elevated potassium level (5.2 mEq/L) could exacerbate hyperkalemia, which can lead to serious cardiac issues. However, this action alone is not sufficient. The nurse must also inform the prescribing physician to reassess the patient’s treatment plan.

Choice C reason:

Giving the ordered KCL as prescribed would be inappropriate in this situation. The patient’s potassium level is already elevated, and administering additional potassium could lead to hyperkalemia, which can cause dangerous cardiac arrhythmias or even cardiac arrest. Therefore, this option should be avoided.

Choice D reason:

Calling the prescribing physician and informing her of the client’s serum potassium level results is the most appropriate action. The physician needs to be aware of the elevated potassium level to make an informed decision about the patient’s treatment plan. The physician may decide to withhold the potassium chloride, order additional tests, or take other actions to manage the patient’s potassium levels safely.

Choice A reason:

Offering the child a choice of taking the medication with juice or water is an effective strategy. Giving children choices helps them feel a sense of control and can reduce resistance. This approach respects the child’s autonomy and can make the medication-taking process less stressful for both the child and the nurse.

Choice B reason:

Telling the child it is candy is not an appropriate strategy. This can lead to mistrust and confusion, as the child may expect candy and be disappointed or upset when they realize it is medication. It is important to be honest with children about what they are taking to build trust and ensure they understand the importance of the medication.

Choice C reason:

Telling the child he will have to have a shot instead is not a helpful approach. This can create fear and anxiety about both the medication and future medical procedures. Using threats or scare tactics can damage the child’s trust in healthcare providers and make them more resistant to treatment in the future.

Choice D reason:

Hiding the medication in a large dish of ice cream is not recommended. While it might seem like an easy way to get the child to take the medication, it can lead to issues with dosage accuracy and the child may develop an aversion to the food used to hide the medication. It is better to use transparent and honest methods to encourage cooperation.