A nurse is reviewing the medical history of a client who is to start taking prednisone.
Which of the following findings should the nurse identify as a contraindication to
prednisone therapy?

To calculate the flow rate in gtt/min, the total volume (350 mL) should be divided by the total time in minutes (3 hours x 60 minutes/hour = 180 minutes). This gives us the mL/min. So, 350 mL / 180 min = 1.944 mL/min.

Since the drop factor is 10 gtt/mL, we then multiply the mL/min by the drop factor to get gtt/min. Therefore, 1.944 mL/min x 10 gtt/mL = 19.44 gtt/min.

When rounded to the nearest whole number, the nurse should set the manual IV infusion to deliver 19 gtt/min.

A. Monitor the client for dysrhythmias- The significant decrease in potassium levels (hypokalemia) can predispose the client to cardiac dysrhythmias, so monitoring for any signs or symptoms of dysrhythmias is essential.
B. Advise the client to restrict potassium intake- With potassium levels already low (hypokalemia), restricting potassium intake further could exacerbate the deficiency. Instead, the client may need to increase their potassium intake through dietary changes or supplementation under healthcare provider guidance.
C. Advise the client to take the medication before bedtime- There's no medication mentioned in the scenario that requires a specific timing like before bedtime.
D. Check the client for orthostatic hypotension- The client reports dizziness and light- headedness upon standing, which are indicative of orthostatic hypotension. Checking for orthostatic hypotension involves measuring blood pressure and heart rate in different positions (lying, sitting, and standing) to assess for postural changes.
E. Advise the client to change positions slowly- Given the client's symptoms of dizziness and light-headedness upon standing, advising them to change positions slowly can help prevent falls or injuries associated with orthostatic hypotension.