A nurse is providing pneumonia vaccinations in a community setting. Due to limited finances, the event organizers must limit giving the vaccination to priority groups. What clients would be considered a priority when administering the pneumonia vaccination? (Select all that apply)

Step 1: Calculate the total infusion time in minutes.

8 hours × 60 minutes/hour = 480 minutes

Result at each step = 480 minutes

Step 2: Calculate the total number of drops to be infused.

1,000 mL × 15 drops/mL = 15,000 drops

Result at each step = 15,000 drops

Step 3: Calculate the infusion rate in drops per minute.

15,000 drops ÷ 480 minutes = 31.25 drops/minute

Result at each step = 31.25 drops/minute

Step 4: Round to the nearest whole number if necessary.

31.25 drops/minute rounds to 31 drops/minute

Result at each step = 31 drops/minute

Therefore, the nurse should run the IV infusion at a rate of 31 drops per minute.

Choice A Reason:

Monitoring the QT interval is crucial when administering amiodarone because this drug can prolong the QT interval, increasing the risk of torsades de pointes, a potentially life-threatening form of ventricular tachycardia. The QT interval represents the time it takes for the heart’s ventricles to depolarize and repolarize, and prolongation can lead to arrhythmias. Regular monitoring helps in early detection and prevention of such adverse effects.

Choice B Reason:

Heart rate monitoring is essential when administering amiodarone because the drug can cause bradycardia (a slower than normal heart rate). Amiodarone affects the electrical conduction system of the heart, which can lead to significant changes in heart rate. Monitoring the heart rate ensures that any bradycardia is detected early and managed appropriately to prevent complications such as hypotension or heart failure.

Choice C Reason:

While respiratory rate monitoring is important in general patient care, it is not specifically necessary for monitoring the effects of amiodarone. Amiodarone primarily affects the heart’s electrical activity and has less direct impact on respiratory function. However, in cases of severe adverse reactions, such as pulmonary toxicity, respiratory monitoring may become relevant.

Choice D Reason:

Monitoring heart rhythm is vital when administering amiodarone because the drug is used to treat arrhythmias and can also cause new arrhythmias or exacerbate existing ones. Continuous ECG monitoring helps in detecting any abnormal heart rhythms early, allowing for timely intervention. This is particularly important in patients with a history of arrhythmias or those receiving high doses of amiodarone.

Choice E Reason:

Urine output monitoring is not specifically necessary for patients receiving amiodarone. While maintaining adequate urine output is important for overall patient health, amiodarone does not typically affect renal function directly. Therefore, urine output monitoring is not a primary concern when administering this medication.