Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
A woman on day 3 after a caesarean has calf pain, swelling and warmth in one leg. What should the nurse do?
At a booking visit, a woman says she drinks heavily most weekends. Which nursing response is most appropriate?
A child weighing 26 kg is prescribed 15 mg/kg of a drug. The stock solution contains 50 mg/mL. Draw up the dose: what volume V do you give?
A patient is 115 cm tall and weighs 36 kg. The prescription is 50 mg/m². Using the Mosteller formula BSA = √(height (cm) × weight (kg)/3600), find the dose D in mg.
Infuse 500 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 drip runs at 30 gtt/min through a set of 60 gtt/mL. There are 400 mL left in the bag. How many hours t until it is empty? Round to one decimal place.
Answer: C · Report it promptly and avoid massaging the leg
One-sided calf pain, swelling and warmth suggest deep vein thrombosis, and the postnatal period is a high-risk time. The leg should not be massaged, and the provider should be informed for urgent assessment.
Answer: D · Explain the risks and refer her for support to stop
Alcohol can harm the fetus throughout pregnancy, and stopping at any point reduces the risk. The nurse gives clear, non-judgemental information and refers her to support services.
Answer: V = 7.8 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: D = 53.62 mg
Body-surface-area dosing: many cytotoxic and some paediatric doses are prescribed per square metre of body surface area: dose (mg) = dose per m² × BSA (m²). The Mosteller formula estimates BSA = √(height (cm) × weight (kg)/3600).
Answer: R = 56 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: 56 gtt/min.
Answer: t = 13.3 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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