A nurse l monitoring an IV for a client who is to receive 120 mL of lactated Ringer's over 1 hr. The drip factor on the manual IV tubing is 15 gtt/mL. The nurse should ensure that the drip rate is set for how many gtt/min? (Round the answer to the nearest whole number. Use leading zero if it applies. Do not use a trailing zero.)

A. Respiratory complaint: A 4-day productive cough with fatigue and night sweats raises concern for a respiratory infection, including tuberculosis (TB) or pneumonia. Further evaluation, including chest imaging and sputum studies, is warranted.
B. Temperature: A low-grade fever (38.1°C/100.5°F) for several days, along with night sweats, suggests a possible infectious process, requiring further investigation.
C. Sputum characteristics: Blood-tinged sputum raises concern for TB, bronchitis, pneumonia, or malignancy, necessitating a sputum culture and acid-fast bacillus (AFB) testing.
D. Weight: Unintentional weight loss (5 lb in 1 week) and decreased appetite can indicate chronic infection, malignancy, or another systemic illness, necessitating further evaluation.
G. Travel history: Recent travel to South Africa, a country with a high TB prevalence, increases the risk of tuberculosis exposure and justifies further screening.
Incorrect Choices:
E. Blood pressure: 112/88 mm Hg is within the normal range and does not require further evaluation.
F. Oxygen saturation: 98% on room air is normal and does not indicate respiratory compromise.
H. Heart rate: 98/min is slightly elevated but could be due to fever or mild dehydration. It is not a primary concern.

A) The child is unable to skate with good balance.
At 4 years old, a child’s balance and coordination are still developing. While skating requires more advanced skills, a child not having good balance at this age is not typically a concern unless other motor skills are delayed. Skating is not an expected milestone for a 4-year-old.

B) The child is unable to jump rope.
Jumping rope is a more complex skill that typically develops later, closer to ages 5 or 6, so the inability to do so at age 4 is not a cause for concern. It is a skill that requires fine motor coordination, balance, and timing, which may not be fully developed at this age.

C) The child is unable to walk downstairs on alternating feet.
At 4 years old, children are expected to be able to walk downstairs using alternating feet (one foot on each step). If a child cannot perform this task, it may indicate a delay in gross motor development, specifically in coordination and balance. This is a developmental milestone that typically emerges by age 4 and should be reported to the physical therapist for further evaluation.

D) The child is unable to walk backwards from heel to toe.
Walking backwards from heel to toe is a more advanced skill that typically develops later in childhood. This skill is not expected at age 4, so the child’s inability to do so is not a red flag for developmental concerns. It is more appropriate for older children.