Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
In the leg check of BUBBLE-HE, how is a postpartum woman assessed for venous thromboembolism today?
A woman on day 2 after a caesarean suddenly has chest pain, breathlessness, a heart rate of 120/min and an oxygen saturation of 90%. What is the priority?
A child weighing 9 kg is prescribed 20 mg/kg of a drug. The stock solution contains 25 mg/mL. Draw up the dose: what volume V do you give?
A child weighing 14 kg is prescribed 20 mg/kg per dose of an oral suspension that contains 200 mg in 5 mL. What volume V do you give?
Infuse 500 mL over 8 hours with a giving set of 15 gtt/mL. Find the drip rate R in drops per minute. Round to the nearest whole number.
A drip runs at 25 gtt/min through a set of 15 gtt/mL. There are 750 mL left in the bag. How many hours t until it is empty?
Answer: D · Look for one-sided swelling, warmth, redness and tenderness of the leg
Homans' sign is unreliable and is no longer recommended. Assess for unilateral swelling, warmth, redness and pain, and report breathlessness or chest pain at once. Massaging the calf could dislodge a clot.
Answer: C · Call for help, sit her up and give oxygen
Sudden breathlessness, chest pain, tachycardia and hypoxia suggest pulmonary embolism, a leading cause of maternal death. The nurse calls for urgent help, positions her upright, gives oxygen and prepares for investigations and anticoagulation.
Answer: V = 7.2 mL
Drawing up a dose: volume = (prescribed dose/stock strength) × stock volume. Convert to the same units first, then check that the volume fits the syringe and lands on one of its graduations.
On this 10 mL syringe every small line is 0.2 mL.
Answer: V = 7 mL
Dose calculation: the amount to give equals what is prescribed divided by what you have, times the quantity it comes in: amount = (desired dose/stock strength) × stock volume. Always keep the units the same (convert g to mg, mg to mcg first) and check that the answer is sensible.
Answer: R = 16 gtt/min
Infusion rates: a pump is set in mL/h = volume/time in hours. A gravity drip is counted in drops per minute: gtt/min = volume (mL) × drop factor (gtt/mL)/time (min). The drop factor is printed on the tubing package: macrodrip sets deliver 10, 15 or 20 gtt/mL (blood sets often 10 gtt/mL in the US, 15 in the UK) and microdrip sets 60 gtt/mL. Always use the drop factor the question or package gives.
At the bedside you round to the nearest whole drop: 16 gtt/min.
Answer: t = 7.5 h
Infusion rates: a pump is set in mL/h = volume/time in hours. A gravity drip is counted in drops per minute: gtt/min = volume (mL) × drop factor (gtt/mL)/time (min). The drop factor is printed on the tubing package: macrodrip sets deliver 10, 15 or 20 gtt/mL (blood sets often 10 gtt/mL in the US, 15 in the UK) and microdrip sets 60 gtt/mL. Always use the drop factor the question or package gives.
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