While preparing an infusion of mannitol (Osmitrol), the nurse notices small crystals in the IV tubing. What is the most appropriate action by the nurse?

Correct Answer: B

Rationale: The most appropriate action by the nurse when small crystals are observed in the IV tubing while preparing an infusion of mannitol (Osmitrol) is to discard the solution and obtain another bag of medication. Small crystals in the IV tubing can indicate that the medication may be contaminated or that it has precipitated out of solution, which can potentially lead to complications if infused into the patient. It is crucial to ensure that the medication is in proper form before administration to prevent any harm to the patient. Therefore, discarding the solution and obtaining a new bag of medication is the safest and most appropriate course of action in this situation.

Correct Answer: B

Rationale: Aging reduces liver/renal clearance, raising plasma levels (e.g., digoxin), heightening response and toxicity risk, per pharmacokinetics. Body water drops, concentrating drugs, not diluting. Doses decrease, not increase-metabolism slows. Absorption may slow, but pH rises, not falls. Plasma increase drives effects, key in elders.

Correct Answer: A

Rationale: Atropine given via intramuscular (IM) injection typically reaches its peak effects within 15 to 50 minutes after administration. The onset of action is relatively rapid, with faster absorption and distribution compared to oral administration. The effects of atropine can be seen within minutes, reaching peak concentration within the specified time frame. This rapid onset is important clinically when atropine is used to treat conditions such as bradycardia or nerve agent poisoning where a quick response is needed.

Correct Answer: A

Rationale: Amphotericin B, an antifungal, is nephrotoxic , damaging renal tubules and reducing GFR, a severe effect needing close monitoring (e.g., creatinine, urine output) to adjust dosing or hydration. Ototoxicity , hepatotoxicity , and cardiotoxicity are less common. Nephrotoxicity's frequency and severity align with amphotericin's membrane-binding mechanism, critical in fungal infections where prolonged use is typical, making A the priority to monitor for renal protection.

Correct Answer: C

Rationale: Redness and pain at the site of the infusion can indicate a potential infiltration or extravasation of the medication, in this case, pentamidine (Pentam) IV. Pentamidine is a medication used to treat Pneumocystis jiroveci (formerly known as Pneumocystis carinii) pneumonia in HIV patients. Infiltration or extravasation of pentamidine can lead to tissue damage, necrosis, and potentially severe complications. Therefore, it is crucial to immediately assess and address any signs of redness and pain at the infusion site to prevent further harm to the patient. This assessment finding should be promptly relayed to the physician for further evaluation and intervention.