Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Which signs suggest a child is ready to start toilet training?
After a week in hospital without his parents, a 2-year-old has stopped crying for his mother, plays with the nurses and seems uninterested when she visits. Which stage of separation does this show?
Practice exercise (made-up values, not clinical guidance). An infusion contains 100 units of regular insulin in 250 mL. The order is 3 units/h. Find the pump rate R 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 35 mL/h. The patient weighs 78 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 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).
Practice exercise (made-up values, not clinical guidance). A 500 mL bag runs by pump at 100 mL/h. At 11:00, 300 mL have already been infused. How many hours t until the bag is empty? Round to one decimal place.
Answer: C · Staying dry for about 2 hours, showing interest and being able to follow simple instructions
Readiness signs include bladder control for a few hours, awareness of a wet nappy, interest in the toilet and the ability to sit, walk and follow simple instructions, usually between about 18 months and 3 years.
Answer: D · Detachment
In detachment, the child seems to adjust and shows interest in surroundings but ignores the parent, as a way of coping with loss. It can be mistaken for settling in. Encouraging parents to stay and keeping routines helps prevent it.
Answer: R = 7.5 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 = 12 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: B = 370 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 = 2 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 2 h 00 min, so the bag runs out at about 13:00.
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