Order: 200 mL normal saline bolus IV over 15 minutes

On hand: 500 mL normal saline bags

What rate will the nurse set the pump to deliver the fluid?

Choice A reason: This is correct because high lipid levels, such as cholesterol and triglycerides, are a risk factor for cardiovascular disease. HMG-CoA reductase inhibitors, also known as statins, lower the production of cholesterol in the liver and reduce the risk of heart attack and stroke.

Choice B reason: This is incorrect because blood glucose of 60 is not related to the need for an HMG-CoA reductase inhibitor. Blood glucose of 60 is below the normal range and may indicate hypoglycemia, which is a low blood sugar level. Hypoglycemia can cause symptoms such as dizziness, confusion, sweating, and hunger.

Choice C reason: This is incorrect because platelets over 150,000 are not related to the need for an HMG-CoA reductase inhibitor. Platelets are blood cells that help with clotting and prevent bleeding. The normal range of platelets is 150,000 to 450,000 per microliter of blood. Platelets over 150,000 are within the normal range and do not indicate a problem.

Choice D reason: This is incorrect because low INR is not related to the need for an HMG-CoA reductase inhibitor. INR stands for international normalized ratio and is a measure of how long it takes the blood to clot. The normal range of INR is 0.8 to 1.2. Low INR means the blood clots faster than normal and may indicate a risk of thrombosis, which is a blood clot in a vein or artery.

Choice A reason: This choice is incorrect because there is no need to recheck the heart rate in one hour before giving the digoxin. The client's apical heart rate is within the normal range (60 to 100 beats per minute) and does not indicate bradycardia (slow heart rate), which is a sign of digoxin toxicity. The nurse should check the apical heart rate for one full minute before giving the digoxin and withhold the dose if the heart rate is below 60 beats per minute.

Choice B reason: This choice is correct because the client's digoxin level is within the therapeutic range (0.5 to 2.0 ng/mL) and does not indicate digoxin toxicity or underdosing. The client's vital signs and labs are also stable and do not indicate any adverse effects of digoxin. Digoxin is a cardiac glycoside that improves the contractility and efficiency of the heart and helps to control the heart rate and rhythm in clients with heart failure. The nurse should give the digoxin as ordered and monitor the client's response and digoxin level.

Choice C reason: This choice is incorrect because there is no indication for a chest x-ray for this client. A chest x-ray is a diagnostic test that can show the size and shape of the heart and lungs and detect any abnormalities, such as fluid accumulation, infection, or tumors. The client's symptoms and labs do not suggest any pulmonary complications or worsening of heart failure that would require a chest x-ray. The nurse should follow the provider's orders and protocols for chest x-ray indications.

Choice D reason: This choice is incorrect because there is no reason to hold the digoxin and call the MD for this client. The client's digoxin level is not too high or too low and does not require dose adjustment or discontinuation. The client's vital signs and labs are also normal and do not indicate any signs of digoxin toxicity or adverse effects. Holding the digoxin could cause the client's heart failure to worsen or cause arrhythmias. The nurse should only hold the digoxin and call the MD if the client has signs of digoxin toxicity, such as nausea, vomiting, visual disturbances, confusion, or bradycardia. .