Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
How is a child usually positioned for a lumbar puncture?
The 7-year-old brother of a child with cancer has started misbehaving at school. What is the most likely explanation?
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 63 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 patient who weighs 59 kg has an order for nitroglycerin at 30 mcg/min. The bag contains 25 mg in 250 mL. Find the pump rate R 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 8-hour shift. The IV infusion ran at the rate shown for the whole shift. Find the total intake I in mL.
Practice exercise (made-up values, not clinical guidance). A 1000 mL bag was started at 10:45 and runs by pump at 80 mL/h. How many mL V are left in the bag at 15:15?
Answer: A · On the side, curled up with knees drawn up and head bent forward
Curling the child on the side (or sitting and bending forward) flexes the spine and widens the spaces between lumbar vertebrae for the needle. A nurse holds the child gently and monitors breathing, as tight flexion can compromise the airway in infants.
Answer: B · He may feel worried, jealous or left out and needs attention and information
Siblings of seriously ill children often feel neglected, anxious, guilty or jealous and may show this through behaviour changes. Family-centred care includes giving siblings age-appropriate information, involvement and time with parents.
Answer: V = 0.88 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: R = 18 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.
The order is per minute for the whole patient, so the weight is not needed.
Answer: I = 1100 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.
Answer: V = 640 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.
ExamProblems · examproblems.com/courses/pediatric-nursing