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

Case Study 21. Spontaneous Abortion

A 31-year-old female is admitted to the hospital to control severe hemorrhage after a spontaneous abortion. The orders from the physician include:

· CBC to determine blood loss

· WBC with differential to rule out infection

· Type and crossmatch for 2 units of blood

· Obtain Coombs' test to determine Rh status

· Administer Rhogam 300 mcg IM if patient is Rh-negative with a negative indirect Coombs' test

· IV D5/0.9% NS at 100 cc/hr

· IV oxytocin (Pitocin) 10 Units infused at 20 mU/min

· Prepare for a dilatation and curettage (D&C)

· Complete bed rest. Monitor bedpan for contents for intrauterine material

· Administer meperidine (Demerol) 50 mg IM q4h for severe discomfort

· Administer ibuprofen 400 mg PO q6h for mild discomfort

· Monitor vital signs q4h for 24 hr

· Monitor urine output

· Note the amount, color, and odor of vaginal bleeding

Identify the orders that require calculations.

Set up and solve each problem using dimensional analysis.

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