Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Which instruction about preparing powdered infant formula is correct?
A 2-week-old suddenly starts vomiting bright green fluid. What should the nurse do?
Practice exercise (made-up values, not clinical guidance). A bag contains 25 000 units of heparin in 250 mL. The order is 15 units/kg/h for a patient who weighs 108 kg. At what rate R do you set the pump, in mL/h? Round to one decimal place.
Practice exercise (made-up values, not clinical guidance). A patient who weighs 70 kg has an order for nitroglycerin at 20 mcg/min. The bag contains 50 mg in 250 mL. Find the pump rate R in mL/h. 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 81 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 1000 mL bag was started at 08:00 and runs by pump at 125 mL/h. How many mL V are left in the bag at 12:00?
Answer: C · Follow the stated water-to-powder ratio exactly and do not warm bottles in a microwave
Formula that is too concentrated can cause dehydration and kidney strain, and over-diluted formula can cause poor growth and low sodium. Microwaves heat unevenly and can leave hot spots that burn the mouth.
Answer: A · Treat it as a surgical emergency and get urgent medical review
Bilious vomiting in a newborn suggests bowel obstruction, such as malrotation with volvulus, which can cut off the blood supply to the gut within hours. It needs immediate surgical assessment.
Answer: R = 16.2 mL/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: R = 6 mL/h
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.
The order is per minute for the whole patient, so the weight is not needed.
Answer: U = 1.47 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: V = 500 mL
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.
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