Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Which newborn is at greatest risk of hypoglycaemia in the first hours after birth?
The triage nurse receives four phone calls from pregnant women. Who should be told to come in immediately?
A patient weighs 80 kg. The prescribed dose is 10 mg/kg per day, given in 2 equal doses. How many milligrams D are given per dose?
A patient weighs 59.4 lb. The prescription is 2 mg/kg as a single dose, and the stock contains 100 mg in 1 mL. Using 1 kg = 2.2 lb, what volume V do you give?
Infuse 1000 mL over 8 hours with a giving set of 10 gtt/mL. Find the drip rate R in drops per minute. Round to the nearest whole number.
500 mL was ordered over 6 hours. After 2 hours you find that 370 mL is still in the bag, and the order must still finish on time. By what percentage Δ must the original pump rate be increased?
Answer: D · A large baby of a mother with diabetes
High maternal glucose crosses the placenta and the fetus makes extra insulin. After the cord is cut, the glucose supply stops but the insulin stays high. Preterm, small and cold babies are also at risk.
Answer: A · At 36 weeks with constant pain and a hard uterus
Constant pain with a hard, tender uterus suggests placental abruption, which can threaten mother and fetus even with little visible bleeding. The other symptoms are common discomforts.
Answer: D = 400 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 = 0.54 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 = 21 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: 21 gtt/min.
Answer: Δ = 11 %
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.
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