Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Which signs suggest meningitis in a young infant?
A baby born to a mother who used opioids in pregnancy has a high-pitched cry, tremors, sneezing and poor feeding. Which plan is best?
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 54 kg. The vial contains 1 000 units/mL. What volume V do you draw up? Round to one decimal place.
Practice exercise (made-up values, not clinical guidance). A dopamine infusion of 800 mg in 500 mL runs at 28 mL/h. The patient weighs 65 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 57 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 infusion starts at 16:00 at 80 mL/h. After 3 hours the rate is changed to 200 mL/h and is not changed again. How many hours t after the start will the bag be empty? Round to one decimal place.
Answer: C · A bulging fontanelle, a high-pitched cry, poor feeding and irritability
Young infants with meningitis may have non-specific signs: fever or low temperature, poor feeding, lethargy or irritability, a high-pitched cry and a bulging fontanelle. Neck stiffness is often absent at this age.
Answer: D · Low-stimulation care, swaddling, small frequent feeds and a withdrawal scoring tool
Neonatal abstinence (withdrawal) is managed first with calm, low-stimulation care, swaddling, frequent feeds and support for parents, with regular scoring to guide any drug treatment. Naloxone is avoided because it can trigger acute withdrawal and seizures.
Answer: V = 3.8 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 = 11.5 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 = 1.21 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 = 6.8 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 6 h 48 min, so the bag runs out at about 22:48.
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