Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
A woman 1 day after birth has a blood pressure of 150/96 mmHg and a headache. She had normal blood pressures in pregnancy. What should the nurse do?
A pregnant woman with chronic hypertension takes lisinopril. Why should the nurse alert the prescriber?
A child weighing 25 kg is prescribed 2 mg/kg of a drug. The stock solution contains 50 mg/mL. Draw up the dose: what volume V do you give?
You must prepare 100 mL of a 1% (w/v) solution from a 25% (w/v) stock solution. How much water W must be added to the stock?
500 mL was ordered over 6 hours. After 4 hours you find that 180 mL is still in the bag, and the order must still finish on time. To what rate R in mL/h must the pump be reset?
A drip runs at 30 gtt/min through a set of 60 gtt/mL. There are 400 mL left in the bag. How many hours t until it is empty? Round to one decimal place.
Answer: D · Report it and assess for postpartum pre-eclampsia
New hypertension with a headache after birth can be postpartum pre-eclampsia, even with normal readings in pregnancy. The nurse reports it, checks urine protein and symptoms and follows the protocol.
Answer: B · ACE inhibitors can harm fetal kidney development and are avoided in pregnancy
ACE inhibitors are fetotoxic, especially in the second and third trimesters, causing fetal kidney damage and oligohydramnios. Labetalol, nifedipine or methyldopa are used instead.
Answer: V = 1 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: W = 96 mL
Solution strengths: a percentage strength is grams per 100 mL, so 1% = 1 g/100 mL = 10 mg/mL. A ratio strength 1:1000 means 1 g in 1000 mL = 1 mg/mL; 1:10 000 is 0.1 mg/mL. For a dilution the amount of drug stays the same: C₁·V₁ = C₂·V₂.
Answer: R = 90 mL/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.
Many hospitals allow such an adjustment up to 25% without a new order; check local policy.
Answer: t = 13.3 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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