Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Practice exercise (made-up values, not clinical guidance). A bag contains 20 000 units of heparin in 500 mL. The order is 14 units/kg/h for a patient who weighs 86 kg. At what rate R do you set the pump, in mL/h? Round to one decimal place.
Practice exercise (made-up values, not clinical guidance). A bag contains dopamine 800 mg in 500 mL. The order is 4 mcg/kg/min for a patient who weighs 91 kg. At what rate R do you set the pump, in mL/h? Round to one decimal place.
A child weighing 11 kg is prescribed 10 mg/kg of a drug. The stock solution contains 25 mg/mL. Draw up the dose: what volume V do you give?
A patient weighs 184.8 lb. The prescription is 0.5 mg/kg as a single dose, and the stock contains 250 mg in 5 mL. Using 1 kg = 2.2 lb, what volume V do you give?
500 mL was ordered over 12 hours. After 7 hours you find that 250 mL is still in the bag, and the order must still finish on time. To what rate R in mL/h must the pump be reset?
A bag contains 250 mg of a drug in 50 mL and runs at 8 mL/h. How many milligrams per hour D does the patient receive?
Answer: R = 30.1 mL/h
Heparin and insulin infusions: concentration = units in the bag/bag volume (units/mL). Pump rate (mL/h) = units per hour/concentration, and units per hour = mL/h × concentration. For a weight-based order, units/h = units/kg/h × weight first. A bolus volume = units needed/vial strength. The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.
Answer: R = 13.7 mL/h
Titrated drips: first find the concentration in mcg/mL (mg × 1000/mL). For a weight-based order, mcg/min = mcg/kg/min × weight. Then mL/h = mcg/min × 60/concentration. Working backwards, mcg/kg/min = mL/h × concentration/(60 × weight). The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.
Answer: V = 4.4 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 = 0.84 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 = 50 mL/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.
Many hospitals allow such an adjustment up to 25% without a new order; check local policy.
Answer: D = 40 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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