Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
A woman has a positive home pregnancy test. How is this sign classified?
Over the last hour, a labour tracing shows variable decelerations that are becoming deeper and longer, a baseline rising from 135 to 165 bpm and falling variability. How should the nurse interpret this?
A child weighing 25 kg is prescribed 10 mg/kg of a drug. The stock solution contains 50 mg/mL. Draw up the dose: what volume V do you give?
A child weighing 14 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?
Infuse 250 mL over 10 hours with a giving set of 60 gtt/mL. Find the drip rate R in drops per minute.
A drip runs at 28 gtt/min through a set of 20 gtt/mL. There are 750 mL left in the bag. How many hours t until it is empty? Round to one decimal place.
Answer: A · A probable sign of pregnancy
A positive hCG test is a probable sign, because hCG can also be raised by a molar pregnancy or some tumours. Only fetal heart activity, fetal movement felt by an examiner or visualisation of the fetus are positive signs.
Answer: A · Evolving fetal hypoxia; escalate for urgent obstetric review
Deepening decelerations with a rising baseline and falling variability show that the fetus is losing its ability to compensate. Intrauterine resuscitation (position change, stopping any oxytocin, treating hypotension) starts and the obstetrician is called urgently, because expedited birth may be needed.
Answer: V = 5 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 = 7 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 = 25 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: t = 8.9 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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