Pediatric Nursing: cram pack

Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.

New problemsBack to the course

In the print window, choose “Save as PDF” to keep a copy on your device.

1Formulas and methods

Pediatric nursing

Method

  1. Note the child’s age first: it sets the normal vital signs, the milestones and the right pain scale.
  2. Assess airway, breathing and circulation, remembering that children compensate and then deteriorate fast.
  3. Match the action to the development stage and involve the family.
  4. Check that the answer is safe for a child: weight-based, no aspirin in viral illness, no codeine under 12.

Pediatric & critical-care dosing

Daily dose
mg/day = mg/kg/day × weight (kg)
Doses per day
number = 24 h / dosing interval (h)
Pounds to kilograms
kg = lb / 2.2
Infusion concentration
units/mL = units in bag / bag volume
Pump rate
mL/h = dose per hour / concentration
Titrated drip
mL/h = mcg/kg/min × kg × 60 / (mcg/mL)
Dose from pump rate
mcg/kg/min = mL/h × (mcg/mL) / (60 × kg)
Units
1 mg = 1000 mcg

IV fluids & fluid balance

Holliday–Segar per hour
4 mL/kg (first 10 kg) + 2 mL/kg (next 10 kg) + 1 mL/kg (each kg above 20)
Holliday–Segar per day
100 / 50 / 20 mL/kg for the same bands
Fluid balance
intake − output
Ice chips
count as half their volume
Urine output
mL/kg/h = mL / (kg × h)
Infusion time
time (h) = volume left (mL) / rate (mL/h)
Volume infused
mL = rate × time

2Practice problems

1.Pediatric nursingMedium

Which activity best supports a 9-year-old during a long hospital stay?

  1. AStaying in bed with no visitors to rest
  2. BSchoolwork and contact with classmates, plus games or hobbies
  3. CWatching television alone for most of the day
  4. DPlaying with baby toys in the toddler playroom with younger children
2.Pediatric nursingHard

Which finding in a 3-month-old with bronchiolitis requires immediate follow-up?

  1. AFeeding slightly less than usual but still with wet nappies
  2. BA runny nose and mild cough
  3. CPauses in breathing (apnoea) and an oxygen saturation of 88%
  4. DWheeze heard on auscultation
3.Pediatric & critical-care dosingMedium
heparin 1 000 units/mL80 units/kg · 106 kg → V = ? mL

Practice exercise (made-up values, not clinical guidance). A practice protocol calls for a heparin bolus of 80 units/kg for a patient who weighs 106 kg. The vial contains 1 000 units/mL. What volume V do you draw up? Round to one decimal place.

80 units/kg106 kg1 000 units/mL
V = mL
4.Pediatric & critical-care dosingHard
8 mg250 mLnorepinephrine? mL/h65 kg10 mcg/min

Practice exercise (made-up values, not clinical guidance). A patient who weighs 65 kg has an order for norepinephrine at 10 mcg/min. The bag contains 8 mg in 250 mL. Find the pump rate R in mL/h. Round to one decimal place.

8 mg/250 mL10 mcg/min65 kg
R = mL/h
5.IV fluids & fluid balanceMedium
IntakeOutput8-hour shiftjuice100 mLtea240 mLice chips120 mLIV infusion50 mL/h × 8 hIV antibiotic1 × 100 mLurine400 mLurine500 mLurine150 mLurine225 mL

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 73 kg. Find the average urine output U in mL/kg/h. Round to two decimal places.

73 kg8 hurine: 400 mLurine: 500 mLurine: 150 mLurine: 225 mL
U = mL/kg/h
6.IV fluids & fluid balanceHard
1000 mL550 mL infused120 mL/h13:30t = ? h

Practice exercise (made-up values, not clinical guidance). A 1000 mL bag runs by pump at 120 mL/h. At 13:30, 550 mL have already been infused. How many hours t until the bag is empty? Round to one decimal place.

1000 mL550 mL infused120 mL/h
t = h

3Solutions

1.Pediatric nursing

Answer: B · Schoolwork and contact with classmates, plus games or hobbies

Why this is the answer

School-age children need to feel competent and connected. Hospital school, contact with friends and age-appropriate games, crafts and collections support Erikson's task of industry and reduce feelings of isolation.

Answer

B · Schoolwork and contact with classmates, plus games or hobbies
2.Pediatric nursing

Answer: C · Pauses in breathing (apnoea) and an oxygen saturation of 88%

Why this is the answer

Apnoea and low oxygen saturation are signs of severe bronchiolitis and need urgent assessment and support. The other findings are typical of mild bronchiolitis.

Answer

C · Pauses in breathing (apnoea) and an oxygen saturation of 88%
3.Pediatric & critical-care dosing

Answer: V = 8.5 mL

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.

Units needed

80·106 = 8 480 units

Volume

V = 8480/1000 = 8.48 ≈ 8.5 mL

Answer

V = 8.5 mL
4.Pediatric & critical-care dosing

Answer: R = 18.8 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.

Concentration

8 000/250 = 32 mcg/mL

Dose per hour

The order is per minute for the whole patient, so the weight is not needed.

10·60 = 600 mcg/h

Pump rate

R = 600/32 = 18.75 ≈ 18.8 mL/h

Answer

R = 18.8 mL/h
5.IV fluids & fluid balance

Answer: U = 2.18 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.

Total urine

400 + 500 + 150 + 225 = 1275 mL

Per kilogram per hour

U = 1275/(73·8) = 2.183 ≈ 2.18 mL/kg/h

Answer

U = 2.18 mL/kg/h
6.IV fluids & fluid balance

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.

Volume left

1000 − 550 = 450 mL

Time

t = 450/120 = 3.75 ≈ 3.8 h

Answer

t = 3.8 h

That is about 3 h 45 min, so the bag runs out at about 17:15.

ExamProblems · examproblems.com/courses/pediatric-nursing