A nurse is preparing to administer lidocaine via continuous IV infusion at 4 mg/min. Available is lidocaine 2 g dextrose 5% in water 500 mL. 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:
Visual disturbances is the correct findings. In individuals taking digoxin, visual disturbances such as blurred or yellow-tinted vision can indicate early signs of medication toxicity. This symptom often requires prompt medical attention, as it can precede more severe complications.
Choice B Reason:
Sudden weight gain is not correct. While weight gain can be a symptom of worsening heart failure, it's not typically associated specifically with digoxin toxicity. It's more commonly related to fluid retention in heart failure.
Choice C Reason:
Potassium 4.4 mEq/L is not correct. This potassium level is within the normal range. Digoxin toxicity can be exacerbated by low potassium levels, but a normal potassium level doesn't directly indicate digoxin toxicity.
Choice D Reason:
Insomnia is not a typical early sign of digoxin toxicity. It's more commonly associated with issues like difficulty sleeping rather than being a direct symptom of digoxin toxicity.

Choice A Reason:
Dark amber urine is incorrect. Dark urine can indicate concentrated urine, often seen in dehydration when the body is trying to conserve water.
Choice B Reason:
Decreased skin turgor is incorrect. Decreased skin turgor is a classic sign of dehydration, indicating that the skin lacks elasticity due to insufficient fluid intake or loss.
Choice C Reason:
Pink, frothy sputum is correct. Normal saline is a common intravenous solution used to treat dehydration. However, in some cases, especially when administered in excessive amounts, it can lead to fluid overload or pulmonary edema. This can manifest as pink, frothy sputum, indicating potential pulmonary congestion or edema, which is a serious adverse effect of fluid overload.
Choice D Reason:
Increased bowel sounds is incorrect. Increased bowel sounds can be seen in various conditions, including gastrointestinal disturbances or hyperactive bowel motility, but it's not typically associated with the adverse effects of normal saline administration.