The healthcare provider prescribes the antibiotic surgical prophylaxis protocol for a client who weighs 90 kg. The protocol is cefazolin 2 grams/100 mL. 0.9% normal saline over 1 hour for clients weighing less than 285.5 pounds or cefazolin 3 grams/100 mL 0.9% normal saline over 90 minutes for clients weighing greater than 265.5 pounds. The nurse should program the pump to deliver how many mL/hr? (Enter number value only. If rounding is required, round to the nearest whole number.)

Answer and Explanation

The Correct Answer is ["100"]

Since the client weighs 90 kg, let’s first convert their weight to pounds to determine the appropriate cefazolin dosage:

Conversion factor: 1 kg = 2.205 pounds

Client weight (pounds) = 90 kg x 2.205 pounds/kg = 198.45 pounds (rounded to two decimals)

Now, comparing the client’s weight (198.45 pounds) to the weight threshold (265.5 pounds):

Client weight is less than the threshold (198.45 pounds < 265.5 pounds).

Therefore, the appropriate dosage is:

Cefazolin 2 grams/100 mL 0.9% normal saline over 1 hour.

The pump rate is determined by the total volume of the IV fluid and the infusion time.

We are not given the specific bag size, but typically these come in 100 mL or 500 mL volumes.

Assuming a 100 mL bag (which aligns with the concentration provided):

Total volume of IV bag: 100 mL

Infusion time: 1 hour

Calculation:

Pump rate (mL/hr) = Total volume (mL) / Infusion time (hr)

Pump rate (mL/hr) = 100 mL / 1 hour = 100 mL/hr

Therefore, the nurse should program the pump to deliver 100 mL/hr.

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Correct Answer is B

Explanation

A) Calms spasm in the urinary tract: This statement is incorrect. Phenazopyridine primarily provides analgesic (pain-relieving) effects for the urinary tract but does not directly affect muscle spasms.

B) Provides an analgesic effect for irritated bladder mucosa: This is the correct response. Phenazopyridine is a urinary tract analgesic that acts locally to relieve pain, burning, and discomfort caused by irritation of the bladder mucosa. It does not treat the underlying infection but helps alleviate symptoms.

C) Eliminates urinary bacteria: This statement is incorrect. Phenazopyridine does not have antibacterial properties and does not eliminate urinary bacteria. Antibiotics are typically prescribed to treat urinary tract infections by targeting bacterial growth.

D) Use the medication after voiding after sexual intercourse: This statement is incorrect. While voiding after sexual intercourse can help reduce the risk of urinary tract infections (UTIs), phenazopyridine is not specifically indicated for this purpose. It is used primarily for symptom relief in cases of cystitis or other urinary tract irritations.

A. Ask the client to describe how she takes the medication. B. Suggest use of an antacid two hours after the medication. C. Remind the client to take the medication with plenty of water. D. Advise the client to go to the nearest emergency department.

Correct Answer is A

Explanation

A) Asking the client to describe how she takes the medication is the most appropriate initial response by the nurse. “Heartburn” reported after taking risedronate raises concerns about potential esophageal irritation or gastroesophageal reflux disease (GERD) exacerbation. Understanding the client’s administration technique (e.g., whether she takes the medication with a full glass of water and remains upright for at least 30 minutes afterward) can help identify potential causes of the reported symptoms.

B) While suggesting the use of an antacid two hours after the medication may provide symptomatic relief, it does not address the underlying issue of potential esophageal irritation or GERD exacerbation related to risedronate administration. Moreover, if the client’s symptoms are due to esophageal irritation, using an antacid may mask the symptoms without addressing the cause.

C) Reminding the client to take the medication with plenty of water is a standard recommendation for bisphosphonate administration to minimize the risk of esophageal irritation and ensure proper drug absorption. However, since the client is already experiencing “heartburn,” further assessment of the client’s medication administration technique is warranted before providing this reminder.

D) Advising the client to go to the nearest emergency department is not appropriate at this stage, as the reported symptom of “heartburn” does not suggest an immediate life-threatening emergency. However, if the client experiences severe chest pain, difficulty swallowing, or signs of a severe allergic reaction (e.g., swelling of the face or throat, difficulty breathing), emergency medical attention would be necessary.

Therefore, the nurse should first assess the client’s medication administration technique to determine if improper administration may be contributing to the reported symptoms. Based on this assessment, appropriate interventions can be provided to address potential esophageal irritation or GERD exacerbation.

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Naxlex Comprehensive Predictor Exams

A client with cystitis receives a prescription for phenazopyridine. Which information should the nurse explain to the client about its therapeutic effect?

Correct Answer is B

Explanation

A female client with osteoporosis has been taking a weekly dose of oral risedronate for several weeks. The client calls the clinic nurse to report increasing “heartburn.” How should the nurse respond?

Correct Answer is A

Explanation

A client with myasthenia gravis receives a now prescription for pyridostigmine. Which information should the nurse obtain to prior to administering the medication?

A client with narcolepsy receives a new prescription for methylphenidate. Prior to administration of the medication, the nurse should review the medical record for which condition?

Before administering the initial dose of sumatriptan succinate to a client with a migraine headache, it is most important to determine if the client's hi’tory includes which problem?

A client is receiving miotics for the treatment of open-angle glaucoma. The nurse determines that a priority nursing problem is a “Risk for injury and this is based on which etiology?

A female client with mild depression reports to the nurse of recently starting St. John's wo’t. Which information provided by the client requires further instruction?

The nurse is administering IV fluconazole to a client who has systemic candidiasis. After reviewing the client's di’gnostic studies, the nurse identifies a rising trend in the liver enzyme levels for aspartate aminotransferase (AST). Which action should the nurse implement?