A child has been prescribed 240 ml of fluid to be administered by micro drip set over 6 hours, the nurse will… - AIIMS Bhatinda NO - 2019

AIIMS Bhatinda NO - 2019

Nursing Foundation

Hard

Appeared in: AIIMS Bhatinda NO - 2019

Explanation

The primary task is to calculate the IV flow rate in drops per minute (gtt/min).
The standard formula is: Flow Rate = (Total Volume [mL] × Drop Factor [gtt/mL]) / Total Time [minutes].
A microdrip set has a fixed drop factor of 60 gtt/mL.
First, calculate the total time in minutes: 6 hours × 60 min/hour = 360 minutes.
Plugging the values into the formula gives: (240 mL × 60 gtt/mL) / 360 min = 40 gtt/min.
A useful shortcut for microdrip sets is that the flow rate in mL/hour equals the flow rate in gtt/min. The hourly rate is 240 mL / 6 hours = 40 mL/hour, which directly translates to 40 gtt/min.

Option A: This rate is four times the correct rate. It would infuse the entire 240 mL in only 1.5 hours instead of 6, posing a severe risk of circulatory overload.
Option B: This rate is three times the correct rate and would infuse the fluid too rapidly, increasing the risk of complications.
Option D: This rate is incorrect. It would be the correct rate if the fluid were to be infused at 60 mL/hour.

Clinical Relevance

Nursing practice connection: Use the key finding related to IV drip rate calculation for a pediatric patient using a microdrip set to guide bedside assessment, documentation, and the next nursing action.
Accurate IV rate calculation is a fundamental nursing responsibility essential for patient safety. Errors can lead to under-dosing, over-dosing, or fluid imbalance.
Microdrip sets are preferred for pediatric patients, the elderly, and when administering critical medications, as they allow for precise control over small fluid volumes, minimizing the risk of accidental fluid overload.
What if the question specified a macrodrip set with a drop factor of 15 gtt/mL? The calculation would change: (40 mL/hr × 15 gtt/mL) / 60 min = 10 gtt/min. The choice of tubing dramatically alters the flow rate.

How to Approach the Question

First, identify all the key values provided in the question: Total Volume (240 mL), Total Time (6 hours), and the type of IV set (microdrip).
Recall the standard drop factor for the specified IV set. A 'microdrip' set always delivers 60 drops (gtt) per mL.
Select the appropriate formula for calculating the drip rate: Rate (gtt/min) = (Volume [mL] × Drop Factor) / Time [min].
Convert the total infusion time from hours to minutes to match the formula's requirements (6 hours × 60 = 360 minutes).
Substitute the known values into the formula and solve: (240 × 60) / 360 = 40.
Alternatively, recognize the shortcut for microdrip sets: the rate in mL/hour is numerically equal to the rate in gtt/min. Calculate the hourly rate (240 mL / 6 hr = 40 mL/hr) to find the answer directly.

Concept Tested & Keywords

Concept Tested: IV drip rate calculation for a pediatric patient using a microdrip set.
Stem keywords: child, 240 ml, micro drip set, 6 hours, regulate IV
Lead-in keywords: regulate IV at
Clinical cues: The term 'child' indicates a pediatric patient, for whom precise fluid administration is critical.
Clinical cues: The term 'micro drip set' specifies a drop factor of 60 gtt/mL.

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