Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
When is the nuchal translucency scan for first-trimester screening usually performed?
A woman at 34 weeks with type 1 diabetes has a blood glucose of 2.8 mmol/L (50 mg/dL), is sweating and shaky but is alert. What should the nurse do first?
A child weighing 34 kg is prescribed 4 mg/kg of a drug. The stock solution contains 20 mg/mL. Draw up the dose: what volume V do you give?
An infusion contains 40000 units of a drug in 500 mL. The prescription is 2000 units per hour. At what rate R do you set the pump, in mL/h?
A drip runs at 50 gtt/min through a set of 20 gtt/mL. How many millilitres V does the patient receive in 8 hours?
A bag contains 100 mg of a drug in 50 mL and runs at 5 mL/h. How many milligrams per hour D does the patient receive?
Answer: C · At about 11 to 14 weeks
Nuchal translucency is measured between about 11 and 14 weeks, often combined with blood markers. The detailed anatomy scan follows at about 18–22 weeks.
Answer: D · Give fast-acting glucose by mouth and recheck
An alert patient with hypoglycaemia is given fast-acting oral carbohydrate, then glucose is rechecked after about 15 minutes and followed by a snack or meal. Treating the mother also protects the fetus.
Answer: V = 6.8 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: R = 25 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: V = 1200 mL
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 = 10 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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