The nurse admits a client with a history of mitral valve stenosis who was admitted to the acute care facility for diagnostic testing related to a suspected diagnosis of prostate cancer. What physician's order would the nurse question?
1. Ambien (zolpidem) 10 mg PO h.s., p.r.n.
2. n.p.o. after midnight.
3. IV of D5W to infuse at 125 mL/hour
4. Erythromycin 1 gram IV 1 hour before procedure
3
Rationale: The client with mitral valve stenosis is at risk for fluid retention, and infusing the IV at 125 mL/hour could cause fluid overload, so the nurse should question this order. A medication to help the client sleep the night before a procedure is a common order, as is n.p.o. at least eight hours before the procedure. Clients with mitral valve stenosis should receive an antibiotic prior to an invasive procedure and then for several days after the procedure to prevent bacterial endocarditis.
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