Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Which antihypertensive is commonly used in pregnancy but should be avoided in a woman with asthma?
One hour after birth, the large baby of a mother with diabetes is jittery and feeding poorly. What should the nurse do first?
A patient weighing 51 kg has a body surface area of 1.31 m². The prescription is 20 mg/m². Find the dose D in mg.
The prescription is 280 units of a drug that comes as 1000 units/mL. Draw up the dose in the 1 mL syringe: what volume V do you give?
An infusion is ordered at 40 mL/h, but no pump is available. It runs by gravity through a giving set of 15 gtt/mL. Find the drip rate R in drops per minute.
A bag contains 400 mg of a drug in 100 mL and runs at 10 mL/h. How many milligrams per hour D does the patient receive?
Answer: D · Labetalol
Labetalol is a beta and alpha blocker and can cause bronchospasm, so it is avoided in asthma. Nifedipine, a calcium channel blocker, is often used instead.
Answer: A · Check the baby's blood glucose
Jitteriness and poor feeding in a high-risk newborn suggest hypoglycaemia. A point-of-care glucose check guides treatment, such as feeding or glucose gel per protocol, with escalation if the level stays low.
Answer: D = 26.2 mg
Body-surface-area dosing: many cytotoxic and some paediatric doses are prescribed per square metre of body surface area: dose (mg) = dose per m² × BSA (m²). The Mosteller formula estimates BSA = √(height (cm) × weight (kg)/3600).
Answer: V = 0.28 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 1 mL syringe every small line is 0.01 mL.
Answer: R = 10 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.
Answer: D = 40 mg/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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