A nurse is preparing to administer methylprednisolone sodium succinate 30 mg/kg via intermittent IV bolus to a client who weighs 169 lb. Available is methylprednisolone sodium succinate 125 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Choice A reason: This choice is incorrect because checking the apical heart rate before taking calcium channel blockers is not necessary for most patients. Calcium channel blockers are a group of medications that relax and widen blood vessels, lower blood pressure, and slow the heart rate. They are used to treat conditions such as hypertension, angina, and arrhythmias. The nurse should check the apical heart rate only if the patient has a history of bradycardia (slow heart rate) or heart block (a problem with the electrical conduction of the heart).

Choice B reason: This choice is incorrect because calcium channel blockers do not cause increased blood pressure, but rather lower it. Blurred vision is not a common side effect of calcium channel blockers, and it may indicate other problems, such as eye infection, glaucoma, or stroke. The nurse should instruct the patient to report any changes in vision, but not to associate them with calcium channel blockers.

Choice C reason: This choice is incorrect because calcium channel blockers do not affect cholesterol levels, and the time of day they are taken does not matter. Cholesterol is a type of fat that circulates in the blood and can build up in the arteries, causing atherosclerosis (hardening and narrowing of the arteries). Cholesterol levels are influenced by diet, exercise, genetics, and other medications, such as statins. The nurse should advise the patient to follow a healthy lifestyle and take any prescribed medications for cholesterol control.

Choice D reason: This choice is correct because grapefruit juice can interact with some calcium channel blockers, such as nifedipine, verapamil, and diltiazem, and increase their blood levels and effects. This can cause serious side effects, such as low blood pressure, dizziness, headache, flushing, and edema (swelling). The nurse should warn the patient to avoid grapefruit juice and any products that contain grapefruit while taking calcium channel blockers.

To calculate the rate at which the nurse should set the IV pump to deliver dextrose 5% in 0.45% sodium chloride over 24 hours, we can use the following steps:

Given:

Total IV fluid volume: 3 L

Infusion duration: 24 hours

Step 1: Convert the total IV fluid volume from liters (L) to milliliters (mL)

Total volume = 3 L × 1000 mL/L

Total volume = 3000 mL

Step 2: Calculate the rate of infusion per hour

Rate = Total volume / Infusion duration

Rate = 3000 mL / 24 hr

Rate ≈ 125 mL/hr

Rounding to the nearest whole number:

Rate ≈ 125 mL/hr

Therefore, the nurse should set the IV pump to deliver approximately 125 mL/hr for the infusion of dextrose 5% in 0.45% sodium chloride over 24 hours.