The healthcare provider prescribes an IV solution of clindamycin 850 mg in 75 ml of D5W to infuse over 30 minutes.

The drop factor is 15 gtt/mL. The nurse should regulate the IV to deliver how many gtt/minute? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

Choice A rationale:

Observing the skin for lesions is not a specific technique for assessing early signs of rheumatoid arthritis. While RA can sometimes manifest with skin lesions, they are not typically present in the early stages of the disease. Moreover, skin lesions can be indicative of a wide range of other conditions, making them a less reliable indicator of RA.

Choice B rationale:

Palpating the lymph nodes is also not a specific technique for assessing early signs of rheumatoid arthritis. Lymph node enlargement can occur in various inflammatory conditions, including infections and autoimmune diseases. It is not a characteristic feature of early RA.

Choice C rationale:

Palpating large joints for nodules is a technique used to assess for rheumatoid arthritis, but it is more likely to detect nodules in later stages of the disease. Nodules are typically firm, non-tender bumps that develop under the skin around joints. They are often found in areas like the elbows, knuckles, and fingers. However, they may not be present in the early stages of RA.

Choice D rationale:

Observing the client's fingers is the most appropriate technique for assessing early signs of rheumatoid arthritis. This is because the fingers are often the first joints to be affected by the disease. Early signs of RA in the fingers can include:

Swelling of the finger joints, particularly the proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints. Tenderness and pain in the finger joints, especially upon movement.

Stiffness in the finger joints, which is often worse in the mornings and after periods of inactivity. Redness or warmth in the finger joints.

Difficulty bending or straightening the fingers.

Choice A rationale:

Incorrect. Open-angle glaucoma is not characterized by an abnormally small angle.

The angle in open-angle glaucoma is open, but the drainage system is not working properly. Therefore, restoring a smaller angle would not be an effective treatment goal.

Choice B rationale:

Incorrect. Eye drops used to treat open-angle glaucoma are not typically used for pain control.

While some individuals may experience mild discomfort associated with elevated eye pressure, pain is not a common symptom of open-angle glaucoma.

Additionally, eye drops used to treat glaucoma do not have anti-inflammatory properties to address swelling.

Choice C rationale:

Incorrect. While reducing excess eye pressure is an important initial goal of treatment, long-term management of open-angle glaucoma requires ongoing maintenance of normal eye pressure.

Simply reducing pressure temporarily is not sufficient to prevent vision loss.

Choice D rationale:

Correct. The primary goal of treatment for open-angle glaucoma is to maintain normal eye pressure over the long term. This is because elevated eye pressure can damage the optic nerve, leading to vision loss.

Eye drops are often used to lower eye pressure, and they typically need to be used for life to prevent vision loss.