Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
A woman at 24 weeks says she craves eating ice and clay. What should the nurse assess for?
A woman at 37 weeks has severe itching of the palms and soles, worse at night, without a rash. Which condition should be considered?
A child weighing 16 kg is prescribed 2 mg/kg of a drug. The stock solution contains 10 mg/mL. Draw up the dose: what volume V do you give?
A child weighing 28 kg is prescribed 10 mg/kg per dose of an oral suspension that contains 100 mg in 5 mL. What volume V do you give?
500 mL was ordered over 6 hours. After 4 hours you find that 180 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 bag contains 250 mg of a drug in 500 mL and runs at 5 mL/h. How many milligrams per hour D does the patient receive?
Answer: D · Iron deficiency anaemia
Pica, the craving for non-food substances, is associated with iron deficiency. Eating clay or soil can also expose the mother to toxins and parasites. Haemoglobin and ferritin should be checked.
Answer: C · Intrahepatic cholestasis of pregnancy
Itching of the hands and feet without a rash suggests intrahepatic cholestasis of pregnancy. Raised bile acids are linked with stillbirth, so liver function and bile acids are checked and timing of birth may be planned.
Answer: V = 3.2 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 = 14 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 = 90 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.
Many hospitals allow such an adjustment up to 25% without a new order; check local policy.
Answer: D = 2.5 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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