Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
A 9-month-old has episodes of severe crying with knees drawn up, and passes a stool that looks like red-currant jelly. What is the likely cause?
On day 5 of chickenpox, a child has a fever again, and one area of skin around some spots has become red, hot, swollen and very painful. What should the nurse suspect?
Practice exercise (made-up values, not clinical guidance). A bag contains 12 500 units of heparin in 250 mL. The order is 14 units/kg/h for a patient who weighs 81 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 bag contains dopamine 800 mg in 500 mL. The order is 2 mcg/kg/min for a patient who weighs 92 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). The record shows a patient's intake and output for one 12-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). Count ice chips as half their volume.
Practice exercise (made-up values, not clinical guidance). A 1000 mL bag runs by pump at 125 mL/h. At 10:00, 200 mL have already been infused. How many hours t until the bag is empty? Round to one decimal place.
Answer: B · Intussusception
Intussusception causes intermittent colicky pain, vomiting, a sausage-shaped mass and stools with blood and mucus. It is an emergency.
Answer: A · A secondary bacterial skin infection
A new fever and spreading redness, heat, swelling and pain around chickenpox lesions suggest secondary bacterial infection, such as with group A streptococcus, which can become serious. The child needs prompt medical review.
Answer: R = 22.7 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 = 6.9 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.
Answer: B = 845 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 = 6.4 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 6 h 24 min, so the bag runs out at about 16:24.
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