What statement by the client indicates that the client understands the nurse's teaching about diuretics?

We are given the following information:

Medication: Ticarcillin/clavulanate 3.1 g

Administration route: Intermittent IV bolus over 30 minutes

Available solution: Ticarcillin/clavulanate 3.1 g in 50 mL 0.9% sodium chloride (NSS)

However, the IV pump controls the rate of delivery over time (usually in hours). An intermittent bolus means the medication is infused all at once over a shorter period (30 minutes in this case).

The pump rate calculation here focuses on the total volume of the available solution containing the medication to be delivered, not necessarily on the medication amount itself.

Therefore, we need to find the rate at which the total volume of 50 mL solution should be delivered over 30 minutes.

Conversion is necessary because pump rates are typically set in hours (hr).

Time (hours) = 30 minutes / 60 minutes/hour = 0.5 hours

Now, calculate the flow rate:

Flow rate (mL/hr) = Total volume (mL) / Infusion time (hours)

Flow rate (mL/hr) = 50 mL / 0.5 hours = 100 mL/hr

Round to the nearest whole number as requested.

Therefore, the nurse should set the pump to deliver approximately 100 mL/hr. This ensures the total 50 mL solution containing the 3.1 g of ticarcillin/clavulanate is delivered over the intended 30-minute period.

A) "Reduce intake of potassium-rich foods":
Hydrochlorothiazide is a diuretic medication that can cause potassium loss through increased urinary excretion. Therefore, instructing the client to reduce intake of potassium-rich foods could further decrease potassium levels, leading to hypokalemia. Instead, clients taking hydrochlorothiazide should be encouraged to consume potassium-rich foods to help maintain normal potassium levels, unless otherwise instructed by their healthcare provider.

B) "Take this medication before bedtime":
While hydrochlorothiazide can be taken once daily, it is typically recommended to take it in the morning rather than before bedtime. Taking the medication earlier in the day can help minimize the need to wake up during the night to urinate, as it is a diuretic that increases urine production. Therefore, instructing the client to take hydrochlorothiazide before bedtime is not the optimal recommendation.

C) "Avoid grape juice":
There is no significant interaction between hydrochlorothiazide and grape juice. In general, grapefruit juice is known to interact with certain medications by inhibiting cytochrome P450 enzymes in the liver, affecting drug metabolism. However, grape juice is not known to interact with hydrochlorothiazide, so advising the client to avoid grape juice is not necessary.

D) "Monitor for leg cramps":
This is the correct instruction. Leg cramps can be a potential side effect of hydrochlorothiazide therapy due to electrolyte imbalances, particularly hypokalemia. By monitoring for leg cramps, the client can promptly report any symptoms to their healthcare provider for further evaluation and management. This instruction promotes client safety and awareness of potential adverse effects associated with the medication."