Clinical Calculations Made Easy: Solving Problems Using Dimensional Analysis, 3rd Edition

Case Study 13. Premature Labor

A 35-year-old female in the 30th week of gestation is admitted to the hospital in premature labor. The orders from the physician include:

·     Bed rest in left lateral position

·     Monitor intake and output

·     Daily weights

·     Continuous fetal monitoring

·     Monitor blood pressure, pulse rate, respirations, fetal heart rate, uterine contraction pattern, and neurologic reflexes

·     Keep calcium gluconate at the bedside

·     Initiate magnesium sulfate 4 g in 250 cc LR loading dose over 20 min, then 2 g in 250 cc LR at 2 g/hr until contractions stop

·     Continue tocolytic therapy with terbutaline (Brethine) 0.25 mg SQ every 30 min for 2 hr after contractions stop

·     Give nifedipine (Procardia) 10 mg sublingual now, then 20 mg PO q6h after infusion of magnesium sulfate and contractions have stopped

·     Betamethasone 12 mg IM × 2 doses 12 hr apart

·     IV LR 1000 cc over 8 hr

Identify the orders that require calculations.

Set up and solve each problem using dimensional analysis.

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