A 40 years old male got admitted in Medical Ward for whom a physician has prescribed Intra Venous fluids. Over a period of 8 hours 2 pints of Normal Saline to be administered. At what rate should the fluid be given?

1. A

   25 ml/hr

2. B

   100 ml/hr

3. C

   125 ml/hr

4. D

   150 ml/hr

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2019

Explanation

• The first step is to convert the prescribed volume from pints to milliliters (mL). One pint is equivalent to approximately 500 mL.
• Calculate the total volume to be infused: 2 pints × 500 mL/pint = 1000 mL.
• Use the standard formula for calculating the hourly infusion rate: Rate (mL/hr) = Total Volume (mL) / Total Time (hours).
• Apply the values to the formula: 1000 mL / 8 hours = 125 mL/hr.
• This calculation ensures the patient receives the correct volume of fluid over the prescribed duration.

Why Other Options Were Wrong

• Option A: An infusion rate of 25 mL/hr would only deliver 200 mL over 8 hours, which is far less than the prescribed 1000 mL.
• Option B: An infusion rate of 100 mL/hr would deliver 800 mL over 8 hours, resulting in a 200 mL deficit of the prescribed fluid.
• Option D: An infusion rate of 150 mL/hr would deliver 1200 mL over 8 hours, which is 200 mL more than ordered. This increases the risk of fluid volume overload.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain IV fluid infusion rate calculation as background academic context rather than a clinical decision trigger.
• Accurate IV fluid calculation is a fundamental nursing responsibility crucial for patient safety. Errors can lead to fluid overload or dehydration, which can cause serious complications, especially in patients with cardiac, renal, or respiratory conditions.
• Nurses must always use an infusion pump for accurate delivery when available and regularly monitor the patient for signs of fluid imbalance (e.g., edema, shortness of breath, changes in blood pressure, or urine output).
• What if? If the patient had severe renal failure, the physician would likely prescribe a much lower volume and rate, and the nurse would need to monitor fluid status even more vigilantly to prevent overload.

How to Approach the Question

• Step 1: Identify the key information provided in the question: the total volume to be infused (2 pints) and the total time for the infusion (8 hours).
• Step 2: Convert the volume to the required unit, which is milliliters (mL). Recall the standard conversion: 1 pint = 500 mL.
• Step 3: Calculate the total volume in mL: 2 pints × 500 mL/pint = 1000 mL.
• Step 4: Identify the required unit for the rate, which is mL per hour (mL/hr).
• Step 5: Apply the formula for calculating the infusion rate: Rate = Total Volume (mL) ÷ Total Time (hours).
• Step 6: Substitute the values into the formula: 1000 mL ÷ 8 hours = 125 mL/hr.

Concept Tested & Keywords

• Concept Tested: IV fluid infusion rate calculation
• Stem keywords: Intra Venous fluids, Normal Saline, 2 pints, 8 hours, rate
• Lead-in keywords: At what rate
• Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
• Clinical cues: The care setting changes urgency, monitoring level, and the expected nursing action.

Question ID

QMu4I0Nvw6E1aklKjWmYb7

Copy ID

Reference Book

E6 Pharmacology Nurses Shanbhag 3e p. 54-56

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 2 p. 107-109