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

How should a parent respond to a 2-year-old's temper tantrum in a safe place?

  1. AStay calm, keep the child safe and do not give in to the demand
  2. BShout loudly at the child to make the tantrum stop sooner
  3. CSmack the child to show that tantrums are not allowed
  4. DGive the child the sweet he wants so the tantrum stops
2.Pediatric nursingHard

Which finding at a 6-month check most needs referral?

  1. AThe baby is wary of a stranger
  2. BThe baby does not turn towards sounds or voices
  3. CThe baby puts every toy and object into the mouth
  4. DThe baby is not crawling yet
3.Pediatric & critical-care dosingMedium
heparin 5 000 units/mL70 units/kg · 86 kg → V = ? mL

Practice exercise (made-up values, not clinical guidance). A practice protocol calls for a heparin bolus of 70 units/kg for a patient who weighs 86 kg. The vial contains 5 000 units/mL. What volume V do you draw up? Round to one decimal place.

70 units/kg86 kg5 000 units/mL
V = mL
4.Pediatric & critical-care dosingHard
400 mg250 mLdopamine8 mL/h75 kg? mcg/kg/min

Practice exercise (made-up values, not clinical guidance). A dopamine infusion of 400 mg in 250 mL runs at 8 mL/h. The patient weighs 75 kg. What dose D in mcg/kg/min is the patient receiving? Round to one decimal place.

400 mg/250 mL8 mL/h75 kg
D = mcg/kg/min
5.IV fluids & fluid balanceMedium
IntakeOutput12-hour shiftjuice100 mLjelly120 mLice chips240 mLIV infusion60 mL/h × 12 hIV antibiotic2 × 50 mLurine250 mLurine325 mLurine400 mLwound drain100 mL

Practice exercise (made-up values, not clinical guidance). The record shows a patient's intake and output for one 12-hour shift. The patient weighs 56 kg. Find the average urine output U in mL/kg/h. Round to two decimal places.

56 kg12 hurine: 250 mLurine: 325 mLurine: 400 mLwound drain: 100 mL
U = mL/kg/h
6.IV fluids & fluid balanceHard
1000 mL80 mL/hstart 11:1519:15: ? mL

Practice exercise (made-up values, not clinical guidance). A 1000 mL bag was started at 11:15 and runs by pump at 80 mL/h. How many mL V are left in the bag at 19:15?

1000 mL80 mL/h11:15 → 19:15
V = mL

3Solutions

1.Pediatric nursing

Answer: A · Stay calm, keep the child safe and do not give in to the demand

Why this is the answer

Tantrums are normal as toddlers seek autonomy but cannot yet manage frustration. Staying calm, keeping the child safe, ignoring the outburst and giving attention for calm behaviour work best; giving in reinforces tantrums.

Answer

A · Stay calm, keep the child safe and do not give in to the demand
2.Pediatric nursing

Answer: B · The baby does not turn towards sounds or voices

Why this is the answer

Not responding to sounds at 6 months may signal hearing loss and needs referral. Crawling usually starts at about 8–10 months, and mouthing objects and wariness of strangers are normal at this age.

Answer

B · The baby does not turn towards sounds or voices
3.Pediatric & critical-care dosing

Answer: V = 1.2 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

70·86 = 6 020 units

Volume

V = 6020/5000 = 1.204 ≈ 1.2 mL

Answer

V = 1.2 mL
4.Pediatric & critical-care dosing

Answer: D = 2.8 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.

Concentration

400 000/250 = 1600 mcg/mL

Micrograms per minute

8·1600 = 12800 mcg/h
12800/60 = 213.3 mcg/min

Per kilogram

D = 213.3/75 = 2.844 ≈ 2.8 mcg/kg/min

Answer

D = 2.8 mcg/kg/min
5.IV fluids & fluid balance

Answer: U = 1.45 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

250 + 325 + 400 = 975 mL

Per kilogram per hour

U = 975/(56·12) = 1.451 ≈ 1.45 mL/kg/h

Answer

U = 1.45 mL/kg/h
6.IV fluids & fluid balance

Answer: V = 360 mL

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.

Elapsed time

11:15 → 19:15 = 8 h

Volume infused

80·8 = 640 mL

Volume left

V = 1000 − 640 = 360 mL

Answer

V = 360 mL

ExamProblems · examproblems.com/courses/pediatric-nursing