Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Why is aspirin used in Kawasaki disease even though it is usually avoided in children?
The parents of a child who is being resuscitated ask to stay in the room. What is the best response?
Practice exercise (made-up values, not clinical guidance). An infusion contains 250 units of regular insulin in 250 mL. The order is 0.1 units/kg/h for a patient who weighs 95 kg. Find the pump rate R in mL/h. Round to one decimal place.
Practice exercise (made-up values, not clinical guidance). A dopamine infusion of 800 mg in 500 mL runs at 25 mL/h. The patient weighs 66 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 IV infusion ran at the rate shown for the whole shift. Find the fluid balance B = intake − output in mL (a negative answer means a net loss).
Practice exercise (made-up values, not clinical guidance). A 1000 mL infusion starts at 13:00 at 150 mL/h. After 2 hours the rate is changed to 75 mL/h and is not changed again. How many hours t after the start will the bag be empty? Round to one decimal place.
Answer: C · It reduces inflammation and the risk of coronary artery clots, under specialist supervision
Kawasaki disease is a vasculitis that can cause coronary artery aneurysms. It is treated with IV immunoglobulin and aspirin under specialist supervision, with echocardiography to check the coronary arteries.
Answer: A · Allow them to stay if they wish, with a staff member to support and explain
Many families want to be present, and guidelines support offering this with a dedicated staff member to explain and support them. Family presence can help with grief and does not generally interfere with resuscitation.
Answer: R = 9.5 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: D = 10.1 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: B = 550 mL
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.
Positive: more fluid went in than came out.
Answer: t = 11.3 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 11 h 20 min, so the bag runs out at about 00:20.
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