A post-op client is to receive the following: D5%W/0.45% NS 1 L to infuse over 5 hours. What is the appropriate setting on an infusion pump in milliliters per hour? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A. Atria is taking longer to depolarize and contract: This would be indicated by a prolonged or abnormal P wave, not a normal PR interval. The rhythm strip shows clearly visible, normal-appearing P waves followed by QRS complexes, ruling this out as the correct interpretation.

B. Conduction time is slowed from the SA node to the ventricles: A slowed conduction time would result in a PR interval longer than 0.20 seconds, characteristic of first-degree AV block. The PR interval on this strip measures within the standard range (0.12–0.20 seconds), so this is not accurate.

C. The PR interval is within the normal time limits: The PR interval on the ECG strip spans about 3 to 4 small boxes (0.12–0.16 seconds), which is within the normal range of 0.12 to 0.20 seconds. This indicates normal conduction from the atria through the AV node to the ventricles.

D. Ventricular repolarization is delayed: Delayed ventricular repolarization refers to a prolonged QT interval, not an abnormality in the PR interval. The PR interval evaluates atrial conduction, not ventricular repolarization, so this is an incorrect association.

A. Maintain the infusion because the client had a cardiac arrest: While epinephrine is essential during cardiac arrest, continuing a high-dose infusion post-resuscitation without reassessment may lead to complications like tachycardia, hypertension, and increased myocardial oxygen demand.

B. Continue to monitor the client's rhythm closely: Ongoing monitoring is important, but it is a passive intervention. The heart rate of 120 bpm may reflect excessive adrenergic stimulation from epinephrine, and further action is needed to prevent deterioration.

C. Suggest that the client's medication be changed to norepinephrine: Norepinephrine is another vasopressor that has less of a beta-1 adrenergic effect compared to epinephrine. It is primarily used for hypotension and septic shock, not as a direct substitute for epinephrine post-cardiac arrest. Changing to another vasopressor without indication is not the best initial step.

D. Ask the physician if the dose can be decreased: A heart rate of 120 bpm may indicate that the epinephrine dose is too high, causing sympathetic overstimulation. Prolonged or excessive tachycardia increases myocardial oxygen demand, which can be detrimental, especially in a post-arrest heart. Decreasing the dose can help prevent arrhythmias or myocardial ischemia, making this the most appropriate and proactive action.