A breastfeeding mother has a hard, tender lump in one breast without fever. She feels well. What is the most likely cause and the best advice?
AA blocked duct; keep feeding and vary positions
BBreast cancer; stop breastfeeding at once
CMastitis; stop feeding from that breast
DA breast abscess; stop breastfeeding completely
3.Pengiraan dosSederhana
Seorang kanak-kanak seberat 16 kg dipreskripsikan 20 mg/kg ubat. Larutan stok mengandungi 40 mg/mL. Sedut dos itu: berapakah isi padu V yang anda berikan?
16 kg20 mg/kg40 mg/mL
V = mL
4.Pengiraan dosSukar
Anda perlu menyediakan 250 mL larutan 2.5% (w/v) daripada larutan stok 20% (w/v). Berapakah isi padu stok V₁ yang anda perlukan?
C₁ = 20%C₂ = 2.5%V₂ = 250 mL
V₁ = mL
5.Kadar infusi IVSederhana
1000 mL diarahkan selama 6 jam. Selepas 2 jam anda mendapati 870 mL masih ada dalam beg, dan arahan itu mesti masih siap tepat pada masanya. Kepada kadar R dalam mL/j berapakah pam mesti ditetapkan semula?
1000 mL / 6 hselepas 2 h: 870 mL
R = mL/h
6.Kadar infusi IVSukar
250 mg ubat dicairkan dalam 250 mL dan diberikan secara graviti melalui set 20 gtt/mL. Arahannya ialah 75 mg sejam. Cari kadar titisan R dalam titisan seminit.
Tachycardia is often the earliest sign, then narrowing pulse pressure, falling blood pressure, pale clammy skin, restlessness and oliguria. Blood pressure may stay normal until a large loss has occurred.
Jawapan
D · Rising pulse, falling blood pressure, low urine output
2.Kejururawatan materniti & obstetrik
Jawapan: A · A blocked duct; keep feeding and vary positions
Mengapa ini jawapannya
A tender lump without fever usually means a blocked duct. Frequent feeding, varied positions and gentle care help clear it. Fever, redness and flu-like symptoms suggest mastitis, which also usually allows continued feeding.
Jawapan
A · A blocked duct; keep feeding and vary positions
3.Pengiraan dos
Jawapan: V = 8 mL
Menyedut dos: isi padu = (dos preskripsi/kekuatan stok) × isi padu stok. Tukarkan kepada unit yang sama dahulu, kemudian semak bahawa isi padu muat dalam picagari dan jatuh pada salah satu tandanya.
Dos daripada berat badan
D = 20·16 = 320 mg
Isi padu
V = 320/40 = 8 mL
Pada picagari
Pada picagari 10 mL ini setiap garisan kecil ialah 0.2 mL.
Jawapan
V = 8 mL
4.Pengiraan dos
Jawapan: V₁ = 31.25 mL
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.
Isi padu stok
V₁ = 2.5·250/20 = 31.25 mL
Jawapan
V₁ = 31.25 mL
5.Kadar infusi IV
Jawapan: R = 217.5 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.
Kadar asal
1000/6 = 166.7 mL/h
Kadar baharu
R = 870/4 = 217.5 mL/h
Jawapan
R = 217.5 mL/h
Ini peningkatan lebih daripada 25%: kebanyakan hospital menghendaki anda menghubungi pegawai yang mempreskripsi dan bukannya mengejar kekurangan, serta menilai pesakit untuk lebihan cecair.
6.Kadar infusi IV
Jawapan: R = 25 gtt/min
Dose-based infusions: concentration = amount of drug in the bag/bag volume. Pump rate (mL/h) = dose per hour/concentration, and dose per hour = mL/h × concentration. Convert per-minute doses to per-hour (× 60) and keep the mass units the same (1 g = 1000 mg, 1 mg = 1000 mcg).