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?
A woman at 30 weeks is in a minor car accident. She feels fine and has no bleeding. What should the nurse advise?
A patient weighs 15 kg and is prescribed 15 mg/kg as a single dose. Find the dose D in mg.
An infusion contains 40000 units of a drug in 250 mL. The prescription is 800 units per hour. At what rate R do you set the pump, in mL/h?
500 mL was ordered over 12 hours. After 8 hours you find that 210 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 40 gtt/min through a set of 15 gtt/mL. There are 400 mL left in the bag. How many hours t until it is empty?
Answer: B · 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: B · Come in for fetal monitoring even without symptoms
Even minor trauma can cause placental abruption, sometimes without bleeding. Pregnant women after trauma are usually monitored with CTG for several hours. Rh-negative women may need anti-D.
Answer: D = 225 mg
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 = 5 mL/h
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 = 52.5 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.
This is more than a 25% increase: most hospitals require you to contact the prescriber instead of catching up, and to assess the patient for fluid overload.
Answer: t = 2.5 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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