Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
How is urine output measured in an infant wearing nappies?
A parent refuses a recommended vaccine for their infant because of fears about side effects. What is the best initial nursing approach?
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 54 kg. The vial contains 5 000 units/mL. What volume V do you draw up? Round to two decimal places.
Practice exercise (made-up values, not clinical guidance). A dobutamine infusion of 250 mg in 250 mL runs at 14 mL/h. The patient weighs 98 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 patient weighs 80 kg. Find the average urine output U in mL/kg/h. Round to two decimal places.
Practice exercise (made-up values, not clinical guidance). A 1000 mL bag runs by pump at 125 mL/h. At 13:00, 400 mL have already been infused. How many hours t until the bag is empty? Round to one decimal place.
Answer: B · Weigh the wet nappy and subtract the dry weight; 1 g is about 1 mL
Weighing nappies before and after use gives an accurate measure of urine output, as 1 g of urine is about 1 mL. This is important in sick infants to calculate output in mL/kg/hour.
Answer: A · Listen to the concerns, give clear evidence-based information and document the discussion
Exploring the parent's specific concerns and giving balanced, accurate information is the most effective approach. Vaccination needs informed consent; the decision and the discussion are documented, and the topic can be revisited later.
Answer: V = 0.86 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.
Answer: D = 2.4 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: U = 0.42 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.
Answer: t = 4.8 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.
That is about 4 h 48 min, so the bag runs out at about 17:48.
ExamProblems · examproblems.com/courses/pediatric-nursing