Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
A child has cola-coloured urine, puffy eyes and high blood pressure two weeks after a sore throat. What is the likely diagnosis?
Newborn pulse oximetry screening shows 97% in the right hand and 91% in the foot. What does this mean?
Practice exercise (made-up values, not clinical guidance). A bag contains 25 000 units of heparin in 250 mL. The order is 14 units/kg/h for a patient who weighs 80 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 dopamine infusion of 800 mg in 500 mL runs at 4 mL/h. The patient weighs 75 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. Count ice chips as half their volume.
Practice exercise (made-up values, not clinical guidance). A 1000 mL bag runs by pump at 150 mL/h. At 22:00, 800 mL have already been infused. How many hours t until the bag is empty? Round to one decimal place.
Answer: A · Acute post-streptococcal glomerulonephritis
Post-streptococcal glomerulonephritis follows a throat infection by about 1–3 weeks (longer after a skin infection) and causes haematuria, oedema and hypertension. Blood pressure, fluid balance and weight are monitored.
Answer: D · An abnormal screen that must be followed up promptly under the screening protocol
The right hand reflects pre-ductal blood and the foot post-ductal blood. A difference of more than 3%, or a reading below about 95% in both limbs, is an abnormal screen. Depending on the protocol this means a prompt repeat test or immediate medical review, with echocardiography if it persists, because it can signal critical congenital heart disease.
Answer: R = 11.2 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: D = 1.4 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 = 1550 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 = 1.3 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 1 h 20 min, so the bag runs out at about 23:20.
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