A child is to receive 500 mL of an I/V solution over 12 hours via tubing that delivers micro drips at 60 drops/mL. The nurse would infuse solution at which of the following rates?

1. A

   42 drops/minute

2. B

   48 drops/minute

3. C

   63 drops/minute

4. D

   84 drops/minute

Appeared in: OSSSC Nursing Officer-2021

Explanation

• The correct rate is found using the standard IV drip rate formula: Rate = (Volume × Drop Factor) / Time.
• First, the total infusion time must be converted from hours to minutes: 12 hours × 60 minutes/hour = 720 minutes.
• Plugging the values into the formula: (500 mL × 60 gtt/mL) / 720 minutes.
• This simplifies to 30,000 / 720, which equals 41.67 gtt/min.
• Rounding 41.67 to the nearest whole number gives 42 drops/minute.

Why Other Options Were Wrong

• Option B: This is a calculation error. A rate of 48 drops/minute would infuse the 500 mL in approximately 10.4 hours, not the prescribed 12 hours.
• Option C: This rate is too fast. It would be the correct rate if the infusion was ordered to run over approximately 8 hours (476 minutes), not 12 hours.
• Option D: This rate is significantly too fast. An infusion at 84 drops/minute would deliver the 500 mL in just under 6 hours, which is twice as fast as ordered.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to IV Drip Rate Calculation to guide bedside assessment, documentation, and the next nursing action.
• Accurate IV drip rate calculation is a fundamental nursing skill essential for patient safety. Incorrect rates can lead to fluid overload or dehydration, especially in vulnerable patients like children and the elderly.
• The use of microdrip tubing is common in pediatrics and for the administration of potent medications that require precise, slow infusion rates.
• What if? If the nurse mistakenly used macrodrip tubing with a drop factor of 15 gtt/mL, the rate would be (500 mL × 15 gtt/mL) / 720 min = 10.4, which rounds to 10 drops/minute. Using the wrong tubing would lead to significant under-infusion.

How to Approach the Question

• First, identify all the given values in the problem: Total Volume (500 mL), Total Time (12 hours), and Drop Factor (60 gtt/mL).
• Recognize that this is a calculation question requiring the standard IV drip rate formula.
• Convert the total time from hours to minutes to match the desired unit (drops per minute). 12 hours x 60 = 720 minutes.
• Substitute the values into the formula: Rate = (500 × 60) / 720.
• Perform the calculation: 30000 / 720 = 41.67.
• Round the result to the nearest whole number as specified by standard nursing practice for drip rates, which gives 42. Select the option that matches.

Concept Tested & Keywords

• Concept Tested: IV Drip Rate Calculation
• Stem keywords: child, 500 mL, I/V solution, 12 hours, micro drips, 60 drops/mL
• Lead-in keywords: infuse solution at which of the following rates
• Clinical cues: Patient is a child, requiring precise fluid administration.
• Clinical cues: Microdrip tubing is specified, which has a standard drop factor of 60 gtt/mL.

Question ID

QvXmW7WOcwE9PiO1hCuu30

Copy ID

Reference Book

E6 Pharmacology Nurses Shanbhag 3e p. 54-56

E6 Nursing Fundamentals Potter Perry 12e Part 5 p. 93-95