A patient is prescribed 500 ml of Normal Saline to be infused over 90 minutes. The drop factor on the tubing is 10 gtt/mL. At what rate should the nurse regulate the IV (gtt/min)? (Round to the nearest whole number)

Step-by-Step Solution:

Convert the client's weight from pounds to kilograms.

1 pound is= 0.453592 kilograms.

220 pounds = 220 x 0.453592 = 99.7664 kilograms.

Calculate the total dose of Alteplase.

The prescribed dose is 0.9 mg/kg.

The client weighs 99.7664 kg.

The total dose = 0.9 mg/kg x 99.7664 kg = 89.8 mg.

Compare the calculated dose with the maximum dose.

The calculated dose (89.8 mg) is less than the maximum dose (90 mg).

Round the answer off to the nearest tenth:

89.9 mg

A. Wheezes on inspiration: Wheezing is typically associated with obstructive pulmonary conditions, such as asthma or chronic obstructive pulmonary disease (COPD), and is caused by narrowing of the airways. In ARDS, the pathophysiology involves inflammation and fluid accumulation in the alveoli, which leads to impaired oxygen exchange but not typically to wheezing. Instead, crackles or rales (a fine, wet sound) are more commonly heard on auscultation in ARDS, particularly as fluid builds up in the alveoli.

B. Blood pressure 170/90: Although ARDS can be associated with hemodynamic instability, elevated blood pressure (170/90 mmHg) is not a typical finding. In fact, ARDS is more commonly associated with low blood pressure or hypotension, particularly if the client is experiencing shock or is on mechanical ventilation. Elevated blood pressure could suggest another issue, such as pain, anxiety, or the use of medications like vasopressors. It is not directly related to the pulmonary edema seen in ARDS.

C. Tachypnea: Tachypnea, or rapid breathing, is a hallmark clinical manifestation of acute respiratory distress syndrome (ARDS). In ARDS, pulmonary edema (fluid accumulation in the lungs) occurs as a result of damage to the alveolar-capillary membrane, leading to impaired gas exchange. The body attempts to compensate for decreased oxygenation by increasing the respiratory rate, leading to tachypnea. This is an early sign of respiratory distress and often precedes hypoxemia and other more severe manifestations. The nurse should closely monitor for tachypnea, as it can indicate worsening respiratory compromise.

D. Bradycardia: Bradycardia, or a slow heart rate, is not typically associated with ARDS. In fact, tachycardia (an elevated heart rate) is more commonly seen in response to hypoxia, respiratory distress, or as a compensatory mechanism for low blood pressure in critical illness. Bradycardia could indicate other issues such as vagal stimulation, medication effects, or electrolyte imbalances but is not characteristic of ARDS itself. 4o mini