A client is admitted because of sickle cell crisis. The client is prescribed fluids at maintenance and the client weighs 85.8 lb. Using the 4-2-1 formula, calculate the client's intravenous flow rate per hour. Round to the nearest whole number.

Step 1 is: Convert the client's weight from pounds to kilograms. 85.8 lb ÷ 2.2 kg/lb = 39 kg. Step 2 is: Determine the flow rate for the first 10 kg. 10 kg × 4 mL/kg/hr = 40 mL/hr. Step 3 is: Determine the flow rate for the next 10 kg (from 11 kg to 20 kg). 10 kg × 2 mL/kg/hr = 20 mL/hr. Step 4 is: Determine the flow rate for the remaining weight over 20 kg. 39 kg – 20 kg = 19 kg. 19 kg × 1 mL/kg/hr = 19 mL/hr. Step 5 is: Calculate the total intravenous flow rate per hour. 40 mL/hr + 20 mL/hr + 19 mL/hr = 79 mL/hr. Step 6 is: Round the final answer to the nearest whole number. 79 mL/hr. The calculated answer is 79 mL/hr.