Which nursing action is the priority intervention for a client diagnosed with total urinary incontinence?

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.

Offer a glass of warm milk. According to some studies, warm milk may have a relaxing effect on the body and help induce sleep. It also contains tryptophan, an amino acid that is converted to serotonin and melatonin, which are neurotransmitters that regulate sleep cycles.

Choice A is wrong because a warm shower may increase the body temperature and make it harder to fall asleep.

Choice C is wrong because notifying the healthcare provider is not necessary for a client with insomnia unless there are other signs of distress or complications.

Choice D is wrong because watching television may stimulate the brain and interfere with the production of melatonin, a hormone that promotes sleep.

Some other nursing interventions for insomnia are:

• Educate the patient on the proper food and fluid intake such as avoiding heavy meals, alcohol, caffeine, or smoking before bedtime.
• Evaluate the patient’s sleep hygiene such as having a regular bedtime and wake-up time, avoiding naps during the day, and limiting exposure to light at night.
• Provide a conducive environment for sleep such as reducing noise, adjusting temperature and lighting, and using comfortable bedding.
• Help the patient develop a sleeping plan such as engaging in relaxing activities before bed, avoiding checking the clock, and getting out of bed if unable to sleep after 20 minutes.
• Understand the proper use of sleep aids or other medications such as following the prescription, avoiding over-the-counter drugs without consulting the provider, and being aware of the side effects and interactions.