A patient is to receive 1000 mL of IV fluid in 6 hours. The drop factor is 15 drops per ml. At approximately how many drops per minute should the flow rate be set?

1. A

   42 drops/min

2. B

   21 drops/min

3. C

   55 drops/min

4. D

   33 drops/min

Appeared in: AIIMS Patna NO - 2020

Explanation

• determined by using the standard formula for IV drip rate calculation: (Total Volume × Drop Factor) / Time in minutes.
• First, convert the total infusion time from hours to minutes: 6 hours × 60 minutes/hour = 360 minutes.
• Next, multiply the total volume (1000 mL) by the drop factor (15 gtt/mL) to get the total number of drops: 1000 × 15 = 15,000 drops.
• Finally, divide the total number of drops by the total time in minutes: 15,000 drops / 360 minutes = 41.67 drops/min.
• Rounding 41.67 to the nearest whole number gives 42 drops/min, which is the correct flow rate to set.

Why Other Options Were Wrong

• Option B: This rate is approximately half of the correct rate. It could be the result of a calculation error, such as incorrectly doubling the infusion time to 12 hours (15000 / 720 ≈ 20.8).
• Option C: This rate is significantly higher than the calculated rate. It likely results from a mathematical error, such as dividing by an incorrect, smaller number of minutes.
• Option D: This rate is lower than the correct rate and does not align with the calculation. It may stem from using an incorrect drop factor or an error in the division step.

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 prevent patient harm. Administering fluids too quickly can lead to fluid volume overload, especially in patients with cardiac or renal conditions. Administering fluids too slowly can result in dehydration or delayed therapeutic effect of medications.
• Nurses must always double-check their calculations, confirm the drop factor on the IV tubing package (macrodrip vs. microdrip), and regularly monitor the patient and the infusion site.
• What if? If the patient had a history of congestive heart failure, the nurse should be extra vigilant. Even with a correctly calculated rate, the nurse would need to frequently assess for signs of fluid overload, such as crackles in the lungs, shortness of breath, and peripheral edema. Any such signs would require immediately slowing the infusion and notifying the healthcare provider.

How to Approach the Question

• This is an analytical question requiring a mathematical calculation.
• First, identify all the necessary variables provided in the question: total volume (1000 mL), total time (6 hours), and the drop factor (15 gtt/mL).
• Recall the standard formula for calculating IV flow rate in drops per minute: (Volume in mL × Drop Factor) / Time in minutes.
• Convert the time from hours to minutes to match the formula's requirement (6 hours * 60 = 360 minutes).
• Substitute the values into the formula: (1000 × 15) / 360.
• Perform the calculation: 15000 / 360 = 41.67.

Concept Tested & Keywords

• Concept Tested: IV flow rate calculation
• Stem keywords: 1000 mL, IV fluid, 6 hours, drop factor, 15 drops per ml, drops per minute
• Lead-in keywords: how many

Question ID

Q-z4Olb57_O0ZesIvt2Oq-

Copy ID

Reference Book

E6 Pharmacology Nurses Shanbhag 3e p. 54-56

E6 Nursing Fundamentals Taylor p. 799-801

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