Which instruction should a nurse include in the teaching plan for a client receiving non-steroidal anti-inflammatory drugs (NSAIDS) for the treatment of rheumatoid arthritis?

To find the rate of the pump in ml/hour, you need to first convert the client’s weight from pounds to kilograms. You can do this by dividing the weight by 2.2046 or multiplying it by 0.454.

For example:

297 lbs / 2.2046 = 134.72 kg or 297 lbs x 0.454 = 134.72 kg

Then, you need to multiply the client’s weight in kilograms by the ordered dose in units/kg/hour to get the total units per hour.

For example:

134.72 kg x 12 units/kg/hour = 1616.64 units/hour

Next, you need to set up a proportion to find the rate of the pump in ml/hour using the supplied medication concentration.

For example:

25,000 units / 500 ml = 1616.64 units / X ml Cross-multiply and solve for X:

25,000 x X = 808320 X = 808320 / 25000 X = 32.33 ml/hour

Finally, you need to round your answer to the nearest tenth of a ml/hour as per the medication administration guidelines.

For example:

32.33 ml/hour ≈ 32.3 ml/hour

Therefore, the rate of the pump is 32.3 ml/hour.

Choice A is wrong because it uses a different conversion factor for pounds to kilograms (1 lb = 0.5 kg) which is not accurate.

Choice C is wrong because it uses a different ordered dose (10 units/kg/hour) which is not what the provider has written.

Choice D is wrong because it uses a different supplied medication concentration (20,000 units in 500 ml) which is not what is available.

Clubbing in upper digits and tripod positioning are signs of chronic obstructive pulmonary disease (COPD), a respiratory disorder that has components of chronic bronchitis and emphysema. Clubbing is a thickening and widening of the fingertips and nails due to chronic low oxygen levels in the blood. Tripod positioning is when the person leans forward and supports their arms on a table or chair to facilitate breathing.

Choice A is wrong because a BMI greater than 30% indicates obesity, which is not a specific sign of COPD, although it can worsen the condition.

Choice C is wrong because AP chest diameter of 1:1 means that the chest is as wide as it is deep, which is also known as barrel chest. This is a sign of emphysema, one of the components of COPD, but not of COPD itself.

Choice E is wrong because high amounts of energy are not associated with COPD. On the contrary, people with COPD often experience fatigue, weakness, and reduced exercise tolerance due to impaired gas exchange and respiratory muscle function.