Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
A woman at 28 weeks is Rh-negative and has a positive antibody screen for anti-D. What does this mean?
The nurse must deliver a baby before the provider arrives. As the head crowns, what should the nurse do?
How many milligrams of drug m are in 10 mL of a 2% (w/v) solution?
A child weighing 16 kg is prescribed 20 mg/kg per dose of an oral suspension that contains 250 mg in 5 mL. What volume V do you give?
Infuse 1500 mL over 12 hours with a giving set of 15 gtt/mL. Find the drip rate R in drops per minute. Round to the nearest whole number.
A bag contains 200 mg of a drug in 100 mL and runs at 5 mL/h. How many milligrams per hour D does the patient receive?
Answer: B · She is sensitised; the fetus is watched for anaemia
If antibodies are already present, anti-D prophylaxis is of no use. Antibody levels are followed and the fetus is monitored for anaemia, often with Doppler of the middle cerebral artery.
Answer: A · Apply gentle pressure to the head to slow the birth
Gentle pressure on the fetal head, with the woman panting, slows birth and reduces perineal tearing and rapid pressure changes in the fetal skull. The nurse then checks for a nuchal cord and supports the baby's body.
Answer: m = 200 mg
Solution strengths: a percentage strength is grams per 100 mL, so 1% = 1 g/100 mL = 10 mg/mL. A ratio strength 1:1000 means 1 g in 1000 mL = 1 mg/mL; 1:10 000 is 0.1 mg/mL. For a dilution the amount of drug stays the same: C₁·V₁ = C₂·V₂.
Answer: V = 6.4 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 = 31 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: 31 gtt/min.
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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