Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
How should a 4-month-old be protected from the sun?
A child with a new forearm cast has severe pain not relieved by analgesia and screams when the nurse gently moves the fingers. What should the nurse suspect?
Practice exercise (made-up values, not clinical guidance). An infusion contains 100 units of regular insulin in 100 mL. The order is 1 unit/h. Find the pump rate R in mL/h. Round to one decimal place.
Practice exercise (made-up values, not clinical guidance). A dobutamine infusion of 500 mg in 250 mL runs at 24 mL/h. The patient weighs 105 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 total intake I in mL.
Practice exercise (made-up values, not clinical guidance). A 500 mL infusion starts at 09:00 at 75 mL/h. After 2 hours the rate is changed to 200 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 · Keep the baby out of direct sun, in the shade, with light clothing and a hat
Babies under about 6 months should be kept out of direct sunlight, protected by shade, clothing and hats. Sunscreen is mainly for older infants and children, on skin that cannot be covered.
Answer: D · Compartment syndrome; report it at once
Rising pressure within a muscle compartment cuts off blood supply. Severe pain unrelieved by analgesia and pain on passive movement are early signs; pulselessness is late. The prescriber is told immediately, the limb is not elevated above heart level and the cast may need splitting.
Answer: R = 1 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 = 7.6 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: I = 1350 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.
Answer: t = 3.8 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 3 h 45 min, so the bag runs out at about 12:45.
ExamProblems · examproblems.com/courses/pediatric-nursing