Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
A newborn with suspected oesophageal atresia is drooling frothy saliva. What is the immediate nursing care?
A 10-year-old with suspected appendicitis has had severe abdominal pain, but it suddenly gets much better. What may this mean?
Practice exercise (made-up values, not clinical guidance). An infusion of 100 units of regular insulin in 100 mL runs at 10 mL/h. How many units per hour D does the patient receive?
Practice exercise (made-up values, not clinical guidance). A dopamine infusion of 400 mg in 250 mL runs at 11 mL/h. The patient weighs 108 kg. What dose D in mcg/kg/min is the patient receiving? Round to one decimal place.
Practice exercise (made-up values, not clinical guidance). The record shows a patient's intake and output for one 8-hour shift. The patient weighs 93 kg. Find the average urine output U in mL/kg/h. Round to two decimal places.
Practice exercise (made-up values, not clinical guidance). A 500 mL bag runs by pump at 80 mL/h. At 15:30, 100 mL have already been infused. How many hours t until the bag is empty? Round to one decimal place.
Answer: C · Keep the baby nil by mouth, raise the head and suction the upper pouch as needed
Nothing is given by mouth because it would pool and be inhaled. The head is raised and a tube in the upper pouch is used for continuous or frequent suction, while the baby is prepared for surgery.
Answer: D · The appendix may have perforated; report it immediately
Sudden relief of pain in appendicitis can indicate perforation, which is followed by peritonitis with worsening pain, fever and rigidity. It needs urgent reporting.
Answer: D = 10 units/h
Heparin and insulin infusions: concentration = units in the bag/bag volume (units/mL). Pump rate (mL/h) = units per hour/concentration, and units per hour = mL/h × concentration. For a weight-based order, units/h = units/kg/h × weight first. A bolus volume = units needed/vial strength. The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.
Answer: D = 2.7 mcg/kg/min
Titrated drips: first find the concentration in mcg/mL (mg × 1000/mL). For a weight-based order, mcg/min = mcg/kg/min × weight. Then mL/h = mcg/min × 60/concentration. Working backwards, mcg/kg/min = mL/h × concentration/(60 × weight). The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.
Answer: U = 0.64 mL/kg/h
Intake and output: intake counts everything that goes in (oral fluids, IV infusions, IV medications and flushes, tube feeds); ice chips count as half their volume. Output counts urine, drains, vomit and other losses. Balance = total intake − total output; a negative balance is a net loss. The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.
Answer: t = 5 h
Infusion time: time (h) = volume to infuse (mL)/rate (mL/h); use the volume still left in the bag, not the bag size. Volume infused = rate × time. Convert decimal hours to hours and minutes with the fraction × 60 (0.5 h = 30 min, not 50 min). The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.
That is about 5 h 00 min, so the bag runs out at about 20:30.
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