A nurse is reviewing the medication orders for a client who has heart failure. Which of the following prescriptions should the nurse clarify with the provider?

A. Dextrose 5% in 0.45% sodium chloride with 20 mEq KCl via continuous IV infusion at 50 mL/hr: This IV fluid with potassium supplementation is generally safe for clients with heart failure as long as potassium levels and fluid balance are monitored closely to prevent overload or electrolyte imbalances. B. Dobutamine 15 mcg/kg via continuous IV infusion: Dobutamine is a positive inotrope used in heart failure to improve cardiac output. The dosage of 15 mcg/kg/min is within the therapeutic range for continuous infusion, making this order appropriate for managing heart failure symptoms. C. Digoxin 2.5 mcg/kg via IV bolus every 8 hr x 2 doses: This dosage is unusually high for digoxin, which is typically dosed in micrograms 0.25 mg (250 mcg) once daily total rather than per kilogram for adults. Such a high dose could lead to digoxin toxicity, especially with frequent IV boluses. D. Bumetanide 0.1 mg/kg via IV bolus every 12 hr: Bumetanide is a loop diuretic commonly used in heart failure to manage fluid overload. The dosage based on weight and the frequency every 12 hours is within acceptable therapeutic parameters, making this order appropriate.