A paediatric patient would receive 500 ml DNS through burette infusion set in 5 hours. Calculate the correct fluid drops per minute?

1. A

   100 macro drops per minute

2. B

   100 micro drops per minute

3. C

   80 macro drops per minute

4. D

   80 micro drops per minute

Appeared in: NORCET -4 , 2023

Explanation

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• The calculation for the IV drip rate is based on the formula: (Total Volume in mL / Total Time in minutes) × Drop Factor.
• A 'burette infusion set' is a type of microdrip set, which has a standard drop factor of 60 drops/mL (gtt/mL).
• Plugging the values into the formula: (500 mL / 300 min) × 60 gtt/mL results in 100 gtt/min.
• Since a microdrip set is used, the correct answer is 100 micro drops per minute.

Why Other Options Were Wrong

• Option A: The calculation of 100 is correct, but the unit 'macro drops' is incorrect. Burette sets are microdrip systems, not macrodrip.
• Option C: Both the calculated value (80) and the unit (macro drops) are incorrect. The calculation is wrong, and a burette set is a microdrip system.
• Option D: While the unit 'micro drops' is correct for a burette set, the calculated value of 80 is incorrect. The correct calculation yields 100.

Related Visual

• Visual 1: Diagram - A side-by-side comparison of a microdrip chamber (with a thin metal stylet) and a macrodrip chamber (with a larger opening) to visually differentiate the two.
• Visual 2: Infographic - A flowchart showing the steps to calculate an IV drip rate, with decision points for choosing between microdrip and macrodrip formulas.

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 fluid calculation is a critical nursing skill, especially in pediatrics, where small errors can lead to fluid overload or dehydration.
• Burette sets (volume-control sets) are used to provide a specific, limited volume of fluid, which is a safety measure to prevent accidental administration of large volumes to vulnerable patients like children.
• What if the patient was an adult requiring rapid fluid resuscitation? A macrodrip set (e.g., 15 gtt/mL) would be used, and the flow rate would be calculated differently to deliver a larger volume quickly.

How to Approach the Question

• Step 1: Identify the key information provided in the question: Total Volume (500 mL), Total Time (5 hours), and type of infusion set (burette).
• Step 2: Recognize that a 'burette infusion set' is a microdrip set. Recall or look up the standard drop factor for a microdrip set, which is 60 gtt/mL.
• Step 3: Convert the total time from hours to minutes (5 hours × 60 min/hour = 300 minutes).
• Step 4: Apply the standard drip rate formula: (Volume / Time) × Drop Factor.
• Step 5: Calculate the result: (500 / 300) × 60 = 100.
• Step 6: Match the calculated number (100) and the correct drop type (micro) to the given options.

Concept Tested & Keywords

• Concept Tested: IV Drip Rate Calculation
• Stem keywords: paediatric patient, 500 ml DNS, burette infusion set, 5 hours
• Lead-in keywords: Calculate, correct fluid drops per minute
• Clinical cues: The term 'paediatric patient' and 'burette infusion set' are crucial clues, indicating a microdrip set (60 gtt/mL) is being used for precision.

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