The doctor orders dextrose 5% in water 1,000 mL to be infused over 8 hours. The IV tubing delivers 15 drops per milliliter. The nurse in charge should run the IV infusion at a rate of:

NOTE: Enter ONLY THE NUMBER DO NOT enter the unit of measurement

Choice A Reason:

Continuing to monitor is the most appropriate action in this scenario. The patient has a regular heart rhythm and a heart rate of 60 beats per minute, which is within the normal range for sinus bradycardia. The PR interval is 0.20 seconds, which is at the upper limit of normal. The patient’s vital signs are stable, with a blood pressure of 118/68 mm Hg, a respiratory rate of 16 breaths per minute, and a temperature of 98.8°F (37°C). There are no signs of hemodynamic instability or symptoms that would necessitate immediate intervention. Therefore, ongoing monitoring is sufficient to ensure the patient’s condition remains stable.

Choice B Reason:

Administering clonidine is not appropriate in this situation. Clonidine is an antihypertensive medication that can lower blood pressure and heart rate. Given that the patient’s blood pressure and heart rate are within normal ranges, administering clonidine could potentially cause hypotension and bradycardia, leading to adverse effects. Therefore, clonidine is not indicated for this patient.

Choice C Reason:

Administering atropine is not necessary for this patient. Atropine is used to treat symptomatic bradycardia, where the heart rate is abnormally slow and causing symptoms such as dizziness, hypotension, or syncope. In this case, the patient’s heart rate is 60 beats per minute, which is within the normal range for sinus bradycardia, and there are no symptoms indicating the need for atropine. Therefore, atropine is not required.

Choice D Reason:

Administering digoxin is also not appropriate. Digoxin is a cardiac glycoside used to treat heart failure and certain types of arrhythmias, such as atrial fibrillation. It can slow the heart rate and increase the force of cardiac contractions. In this scenario, the patient does not have any indications for digoxin therapy, such as heart failure or atrial fibrillation, and their heart rate is already within the normal range. Therefore, digoxin is not indicated.

Choice A Reason:

A decreased thyroxine (T4) level is not expected in a client with Graves’ disease. Graves’ disease is an autoimmune disorder that leads to hyperthyroidism, where the thyroid gland produces excessive amounts of thyroid hormones, including T4. Therefore, the T4 level is typically elevated, not decreased.

Choice B Reason:

Similarly, a decreased triiodothyronine (T3) level is not expected in Graves’ disease. Like T4, T3 levels are usually elevated due to the overactive thyroid gland. T3 is the active form of thyroid hormone and is often increased in hyperthyroid conditions.

Choice C Reason:

Decreased thyroid-stimulating immunoglobulins (TSI) percentage is incorrect. In Graves’ disease, TSI levels are elevated because these antibodies stimulate the thyroid gland to produce more thyroid hormones. TSI mimics the action of TSH, leading to increased production of T3 and T4.

Choice D Reason:

Decreased thyroid-stimulating hormone (TSH) level is the correct answer. In Graves’ disease, the excessive thyroid hormones (T3 and T4) exert negative feedback on the pituitary gland, leading to suppressed TSH production. Therefore, TSH levels are typically low in patients with Graves’ disease.