A nurse is preparing to administer total parental nutrition (TPN) 1800 mL to infuse over 24 hr. 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.)

A. "I'll be glad when I can stop taking this medicine.": This statement indicates a misunderstanding about phenytoin therapy. Phenytoin is typically a long-term medication used to prevent seizures, and it is not typically discontinued unless under the guidance of a healthcare provider. The nurse should clarify that stopping the medication abruptly can lead to rebound seizures and should emphasize the importance of continuing the medication as prescribed.

B. "I have made an appointment to see my dentist next week.": This statement indicates appropriate understanding, as regular dental check-ups are important for individuals taking phenytoin due to the medication's potential side effect of gingival hyperplasia.

C. "I know that I cannot switch brands of this medication.": This statement demonstrates understanding, as different brands of phenytoin can have variations in bioavailability, which can affect seizure control. It is important for clients to remain consistent with the same brand or formulation unless directed otherwise by their healthcare provider.

D. "I will notify my doctor before taking any other medications.": This statement indicates understanding of the potential for drug interactions with phenytoin, as it is a hepatic enzyme inducer and can affect the metabolism of other medications. Clients should always consult their healthcare provider before taking any new medications or supplements to ensure compatibility with phenytoin therapy.

Children can often be resistant to taking medication, but offering them choices and involving them in the process can help promote cooperation. Here's the rationale for each option:

A. Tell the child it is candy: This strategy involves deception and can lead to trust issues if the child discovers the truth. It's not ethical or recommended to lie to a child about medication.

B. Tell the child he will have to have a shot instead: Threatening the child with a shot is coercive and can cause fear and anxiety. It's not an appropriate or therapeutic approach to encourage cooperation.

C. Hide the medication in a large dish of ice cream: While hiding medication in food may work for some children, it's important to ensure that the child consumes the entire dose. Additionally, it's essential to check with the healthcare provider or pharmacist to confirm that the medication can be taken with food. However, this approach may not address the underlying issue of the child's resistance to taking medication.

D. Offer the child a choice of taking the medication with juice or water: Offering the child a choice empowers them and gives them some control over the situation. By allowing the child to choose how they take the medication, they may feel more comfortable and cooperative. This approach respects the child's autonomy and can be an effective way to encourage cooperation while ensuring the medication is taken as prescribed.