Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Which statement describes the "4 Ts" causes of postpartum haemorrhage?
A student nurse is caring for a newborn receiving phototherapy for jaundice. Which action requires correction?
A patient weighs 18 kg. The prescribed dose is 30 mg/kg per day, given in 4 equal doses. How many milligrams D are given per dose?
A patient weighs 88 lb. The prescription is 0.5 mg/kg as a single dose, and the stock contains 40 mg in 1 mL. Using 1 kg = 2.2 lb, what volume V do you give?
Infuse 250 mL over 10 hours with a giving set of 20 gtt/mL. Find the drip rate R in drops per minute. Round to the nearest whole number.
A drip runs at 40 gtt/min through a set of 15 gtt/mL. There are 450 mL left in the bag. How many hours t until it is empty? Round to one decimal place.
Answer: A · Tone, trauma, tissue and thrombin
The 4 Ts are tone (atony), trauma (tears, haematomas, rupture), tissue (retained placenta or clots) and thrombin (clotting disorders). Tone is the most common cause.
Answer: D · Applying baby oil to the skin before the lights are switched on
Oils and lotions can cause burns under phototherapy lights and should not be applied. Eye shields protect the retina, temperature and hydration are monitored because of increased fluid loss, and feeds are an opportunity for eye contact without the shields.
Answer: D = 135 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: V = 0.5 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 = 8 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: 8 gtt/min.
Answer: t = 2.8 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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