Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
What should parents be taught about the water for a newborn's bath?
After a severe postpartum haemorrhage, a woman cannot breastfeed because her milk does not come in, and she feels very tired. Which condition should be suspected?
A child weighing 8 kg is prescribed 10 mg/kg of a drug. The stock solution contains 20 mg/mL. Draw up the dose: what volume V do you give?
A child weighing 12 kg is prescribed 12.5 mg/kg per dose of an oral suspension that contains 250 mg in 5 mL. What volume V do you give?
An infusion is ordered at 30 mL/h, but no pump is available. It runs by gravity through a giving set of 10 gtt/mL. Find the drip rate R in drops per minute.
1500 mL was ordered over 8 hours. After 3 hours you find that 1160 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: A · Check that it is warm, not hot, before the baby goes in
Bath water should be comfortably warm, about 37 °C (98.6 °F), checked with a thermometer or the elbow, and the baby is never left alone, even in shallow water. Plain water or a mild baby cleanser is used. Some guidance, such as in the US, advises sponge baths until the cord stump has fallen off.
Answer: C · Sheehan syndrome
Sheehan syndrome is pituitary necrosis from severe blood loss and hypotension. Low prolactin causes lactation failure, and other hormone deficiencies cause fatigue, low blood pressure and absent periods.
Answer: V = 4 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: V = 3 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 = 5 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: Δ = 23.73 %
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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