A patient is to receive 2000 ml of IV fluid in 12 hours. The Drop factor is 10gtt/ml. At how many drops per minute should the flow rate be set?

1. A

   22 drops/min

2. B

   24 drops/min

3. C

   26 drops/min

4. D

   28 drops/min

Appeared in: WCL Staff Nurse - 2019

Explanation

• derived using the standard formula for IV drip rate calculation.
• First, convert the total infusion time from hours to minutes: 12 hours × 60 minutes/hour = 720 minutes.
• Apply the formula: Drip Rate = (Total Volume in mL × Drop Factor in gtt/mL) / Time in minutes.
• Substitute the given values: (2000 mL × 10 gtt/mL) / 720 minutes = 20000 / 720.
• The result is approximately 27.78 gtt/min.
• Since drops must be whole numbers, the rate is rounded to the nearest whole number, which is 28 drops/min.

Why Other Options Were Wrong

• Option A: A rate of 22 drops/min would significantly under-infuse the patient, delivering only 1584 mL over 12 hours instead of the prescribed 2000 mL.
• Option B: A rate of 24 drops/min would result in under-infusion. The patient would receive 1728 mL over 12 hours, which is 272 mL less than the ordered amount.
• Option C: A rate of 26 drops/min is closer but still incorrect. It would deliver 1872 mL over 12 hours, leaving a deficit of 128 mL.

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 flow rate calculation is a fundamental nursing skill to ensure patient safety and therapeutic effectiveness. Incorrect rates can lead to fluid overload or inadequate hydration/medication delivery.
• While manual drip rate calculation is a key skill, electronic infusion devices (EIDs or 'smart pumps') are the standard of care in most settings for precise and safe administration, especially for critical medications or high-risk patients.
• What if? If the patient had a history of heart failure, the nurse would need to be extra vigilant. Even with the correct rate, the nurse must continuously monitor for signs of fluid volume overload (e.g., crackles in the lungs, edema, shortness of breath) because the patient's heart may not tolerate the fluid load.

How to Approach the Question

• First, identify all the variables given in the problem: Total Volume (2000 mL), Total Time (12 hours), and Drop Factor (10 gtt/mL).
• Recognize that the question asks for the rate in 'drops per minute'. This is a cue that you need to convert the total time from hours to minutes.
• Recall or look up the standard formula for IV drip rate: Rate = (Volume × Drop Factor) / Time in minutes.
• Perform the unit conversion: 12 hours * 60 min/hour = 720 minutes.
• Substitute the values into the formula: (2000 * 10) / 720.
• Calculate the result and remember to round to the nearest whole number, as partial drops cannot be administered.

Concept Tested & Keywords

• Concept Tested: IV Drip Rate Calculation
• Stem keywords: IV fluid, 2000 ml, 12 hours, Drop factor, 10gtt/ml, drops per minute
• Lead-in keywords: how many

Question ID

QzJMoY4TEZGnTkFq3de4JD

Copy ID

Reference Book

E6 Pharmacology Nurses Shanbhag 3e p. 54-56

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

E6 Nursing Fundamentals Taylor p. 799-801