Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
A woman 1 day after birth has a blood pressure of 150/96 mmHg and a headache. She had normal blood pressures in pregnancy. What should the nurse do?
A woman with a previous caesarean is having a trial of labour. Which induction agent should the nurse question?
A child weighing 12 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?
An infusion contains 25000 units of a drug in 1000 mL. The prescription is 1200 units per hour. At what rate R do you set the pump, in mL/h?
Infuse 250 mL over 3 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 bag contains 250 mg of a drug in 100 mL and runs at 12 mL/h. How many milligrams per hour D does the patient receive?
Answer: B · Report it and assess for postpartum pre-eclampsia
New hypertension with a headache after birth can be postpartum pre-eclampsia, even with normal readings in pregnancy. The nurse reports it, checks urine protein and symptoms and follows the protocol.
Answer: C · Misoprostol
Misoprostol is avoided in women with a uterine scar because of a high risk of uterine rupture. Mechanical methods, amniotomy and carefully monitored oxytocin may be used.
Answer: V = 6 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 = 48 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: R = 28 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: 28 gtt/min.
Answer: D = 30 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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