A Primary health care provider prescribes 2000 ml of 5% dextrose and 1/2 normal saline to infuse over 24 hours. The drop factor is 15 drops (gtts)/ml. The nursing officer sets the flow rate at how many drops per minute?

Appeared in: NORCET 3 - 2022 (Shift-1)

Explanation

derived using the standard formula for IV drip rate calculation: (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: (2000 mL × 15 gtt/mL) / 1440 min.
This simplifies to 30000 / 1440, which equals 20.83.
Since drops must be whole numbers, 20.83 is rounded to the nearest whole number, which is 21 gtt/min.

Option A: A rate of 17 gtt/min is too slow. Over 24 hours, it would only deliver approximately 1632 mL, which is significantly less than the prescribed 2000 mL.
Option C: A rate of 28 gtt/min is too fast. It would deliver the 2000 mL in about 18 hours, not the prescribed 24 hours, potentially leading to fluid overload.
Option D: A rate of 30 gtt/min is too fast. It would deliver the 2000 mL in approximately 16.7 hours, significantly faster than the prescribed 24 hours.

Visual 1: Infographic: A visual breakdown of the IV flow rate formula: Drip Rate = (Volume × Drop Factor) / Time. Each component should be clearly defined with examples.
Visual 2: Chart: A comparison table of Macrodrip (10, 15, 20 gtt/mL) and Microdrip (60 gtt/mL) tubing, showing their typical uses (e.g., rapid infusion vs. pediatrics/precise dosing).

Clinical Relevance

Nursing practice connection: Knowing IV Flow Rate Calculation helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Accurate IV flow rate calculation is a critical nursing skill to prevent complications like fluid overload or under-hydration. Errors can have serious consequences, especially in vulnerable patients (e.g., elderly, pediatric, cardiac, or renal patients).
Nurses must monitor patients receiving IV fluids for signs of complications. Signs of fluid overload include shortness of breath, crackles in the lungs, and edema. Signs of dehydration include dry mucous membranes and tachycardia.
What if the drop factor was 60 gtt/mL (microdrip)? The calculation would be (2000 × 60) / 1440 = 83.3, which rounds to 83 gtt/min. This demonstrates how the type of IV tubing drastically changes the required flow rate.

How to Approach the Question

First, identify the question as a calculation problem requiring a specific formula.
Identify all the necessary components from the problem: Total Volume (2000 mL), Total Time (24 hours), and Drop Factor (15 gtt/mL).
Recall or look up the formula for IV drip rate: (Volume × Drop Factor) / Time in minutes.
Notice the units mismatch between the time given (hours) and the time required by the formula (minutes). Convert 24 hours to minutes (24 × 60 = 1440).
Substitute the values into the formula: (2000 × 15) / 1440.
Perform the calculation and round the final answer to the nearest whole number, as partial drops are not possible.

Concept Tested & Keywords

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Practise the full NORCET 3 - 2022 (Shift-1)

Attempt every question from this paper in a timed mock, then review the full solution for each one.