The healthcare provider (HCP) prescribes 1 liter of 0.9% sodium chloride, USP IV to be infused over 12 hours for a client. How many mL/hr should the nurse program the infusion pump to deliver?

(Enter numerical value only. If rounding is required, round to the nearest whole number.)

A. Hold one nostril closed while spraying the other nostril: Closing one nostril while administering the spray ensures the medication is delivered more effectively into the nasal passages, allowing for better absorption and symptom control by maximizing the contact of the medication with the nasal mucosa.

B. Use the inhaler when first awakening in the morning: The specific timing of intranasal corticosteroid use may vary depending on the healthcare provider's instructions and the client's symptom pattern. While morning use can be beneficial due to peak allergy symptoms, it is not the most critical technique instruction. Proper administration ensures better drug efficacy regardless of timing.

C. Avoid shaking the inhaler immediately before using: Some nasal sprays, especially suspensions, require shaking to evenly distribute the medication. Advising not to shake could lead to inconsistent dosing and reduced effectiveness, depending on the specific medication.

D. Angle the tip of the inhaler upward while spraying: The inhaler tip should be angled slightly outward toward the ear, not straight upward, to target the correct nasal structures. Spraying directly upward could lead to discomfort or less effective drug delivery.

Blood glucose 218 mg/dL (12.1 mmol/L)

• Classification: Unrelated Finding

• Rationale: Minoxidil does not influence blood glucose levels. This elevated blood glucose is likely related to the patient’s known history of type 2 diabetes mellitus. It's not a side effect or intended therapeutic action of minoxidil.

Dizziness while sitting up

• Classification: Nontherapeutic Side Effect

• Rationale: Minoxidil is a vasodilator that can cause a rapid drop in blood pressure, particularly when changing positions (orthostatic hypotension). Dizziness is a common side effect due to decreased cerebral perfusion when blood pressure drops too quickly or too much.

Blood pressure 162/111 mm Hg

• Classification: Therapeutic Result

• Rationale: On admission, the patient’s BP was dangerously high at 203/166 mm Hg. A subsequent reading of 162/111 mm Hg shows a significant drop, indicating that minoxidil is having the desired therapeutic effect of lowering blood pressure, even though it's still above target.

Pain rated at 1 on a 0 to 10 scale

• Classification: Unrelated Finding

• Rationale: Minoxidil is not a pain medication and does not impact pain perception. A low pain score of 1 is likely due to an unrelated mild discomfort or pre-existing condition and has no connection to minoxidil's effects.

Urine output 600 mL

• Classification: Unrelated Finding

• Rationale: Minoxidil may cause fluid retention, but 600 mL urine output is within the normal range over a few hours (depending on timing and context). This measurement alone does not indicate a therapeutic or side effect of the drug, and without signs of oliguria or diuresis, it remains unrelated.