A pediatric patient has an IV with a microdrip. The order is for ...

[rmenurse]

A pediatric patient has an IV with a microdrip. The order is for 40 mL/hr to infuse. At what rate does the nurse set the microdrip?
 
  a. 10 gtt/min
  b. 20 gtt/min
  c. 40 gtt/min
  d. 80 gtt/min

Question 2

Which of the following represents appropriate technique when providing care for a patient with chest tubes?
 
  a. Applying an occlusive dressing over the site
  b. Stripping the tube on a regular basis
  c. Assessing the patient hourly after insertion
  d. Keeping excess loops of tubing from hanging over the side of the bed

[mfedorka]

Answer to Question 1

C
Select one of the following formulas to calculate drop rate based on drops per minute: mL/hr/60 min = mL/min followed by Drop factor  mL/min = drops/min, or mL/hr  Drop factor/60 min = drops/min. In this case, 40 mL/hr 60 gtt/mL = 240 gtt/hr 1 hr/60 min = 40 gtt/min. When microdrip is used, mL/hr always equals gtt/min.

Answer to Question 2

D
Lay excess tubing horizontally on the mattress next to the patient. Secure with a rubber band and safety pin or with the system's clamp. This prevents excess tubing from hanging over the edge of the mattress in a dependent loop. Drainage could collect in the loop and occlude the drainage system. Physician responsibility in chest tube placement includes covering the insertion site with sterile petroleum gauze, 4  4-inch gauze, and a large dressing to form an occlusive dressing supported with an elastic bandage. Strip or milk the chest tube only if indicated (this means compressing the tube to encourage clots to press through the tube). Stripping may cause complications because it creates excessive negative intrapleural pressure. Check agency policy. Monitor vital signs, SaO2, and the insertion site every 15 minutes for the first 2 hours.