A patient is receiving 3000 ml of 0.9% NaCl IV in 24 hours. The intravenous set delivers 15 drops per milliliter. The nurse should regulate the flow rate so the patient receives how many drops of fluid per minute?

1. A

   21

2. B

   28

3. C

   31

4. D

   42

Appeared in: GMCH Chandigarh - 2019

Explanation

• determined by using the standard formula for calculating IV drip rates: Drip Rate (gtt/min) = (Total Volume in mL × Drop Factor) / Time in minutes.
• First, convert the total infusion time from hours to minutes: 24 hours × 60 minutes/hour = 1440 minutes.
• Next, plug the values into the formula: (3000 mL × 15 gtt/mL) / 1440 minutes.
• This calculation results in 45000 / 1440, which equals 31.25.
• Since a partial drop cannot be administered, the rate is rounded to the nearest whole number, which is 31 gtt/min.

Why Other Options Were Wrong

• Option A: A flow rate of 21 gtt/min is too slow and would result in under-infusion, meaning the patient would not receive the prescribed fluid volume within the 24-hour period.
• Option B: A flow rate of 28 gtt/min is also too slow and would lead to under-infusion of the prescribed 3000 mL of fluid.
• Option D: A flow rate of 42 gtt/min is too fast. This would lead to over-infusion, delivering the fluid too quickly and potentially causing fluid overload, especially in vulnerable patients.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to IV flow rate calculation to guide bedside assessment, documentation, and the next nursing action.
• Accurate IV flow rate calculation is a critical nursing skill to ensure patient safety. Incorrect rates can lead to serious complications like fluid overload (if too fast) or dehydration and inadequate medication delivery (if too slow).
• Patients receiving large volumes of IV fluids, especially older adults or those with cardiac or renal disease, must be monitored closely for signs of fluid volume excess, such as crackles in the lungs, shortness of breath, edema, and rising blood pressure.
• What if? If the patient had a microdrip set (60 gtt/mL) instead of a macrodrip set, the flow rate would be significantly different. The calculation would be (3000 mL × 60 gtt/mL) / 1440 min = 125 gtt/min. This highlights the importance of always checking the drop factor on the IV tubing package.

How to Approach the Question

• First, identify all the necessary components for the calculation provided in the question: total volume (3000 mL), total time (24 hours), and the drop factor (15 gtt/mL).
• Recognize that the question asks for the rate in 'drops per minute', which means you need to convert the total time from hours to minutes.
• Recall or look up the standard formula for calculating IV drip rates: (Volume × Drop Factor) / Time in minutes.
• Perform the unit conversion: 24 hours * 60 min/hour = 1440 minutes.
• Substitute the values into the formula: (3000 * 15) / 1440.
• Calculate the result and round to the nearest whole number, as partial drops cannot be administered. Select the option that matches your final answer.

Concept Tested & Keywords

• Concept Tested: IV flow rate calculation
• Stem keywords: 3000 ml, 0.9% NaCl, 24 hours, 15 drops per milliliter, drops of fluid per minute
• Lead-in keywords: how many

Question ID

QpcMuYVsBtpLUKV-OvfmQ2

Copy ID

Reference Book

E6 Pharmacology Nurses Shanbhag 3e p. 54-56

E6 Nursing Fundamentals Potter Perry 12e Part 5 pp. 93-95, 94-96