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 newborn's bilirubin is rising quickly at 30 hours despite phototherapy, and the baby is lethargic with an arched back and high-pitched cry. What does this suggest?
A patient weighs 30 kg and is prescribed 10 mg/kg as a single dose. Find the dose D in mg.
An infusion contains 40000 units of a drug in 250 mL. The prescription is 800 units per hour. At what rate R do you set the pump, in mL/h?
An infusion is ordered at 50 mL/h, but no pump is available. It runs by gravity through a giving set of 60 gtt/mL. Find the drip rate R in drops per minute.
A drip runs at 42 gtt/min through a set of 15 gtt/mL. There are 600 mL left in the bag. How many hours t until it is empty? Round to one decimal place.
Answer: B · 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: B · Acute bilirubin encephalopathy
Lethargy, poor feeding, hypertonia with arching and a high-pitched cry are signs of acute bilirubin encephalopathy. An urgent exchange transfusion may be needed to prevent permanent kernicterus.
Answer: D = 300 mg
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 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 = 50 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.
With a microdrip set (60 gtt/mL), gtt/min equals mL/h.
Answer: t = 3.6 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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