Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Why are IV fluids for young children given with an infusion pump or a volume-control set?
A toddler with sickle cell disease suddenly becomes pale and lethargic, with a fast heart rate and an enlarging left upper abdomen. What should the nurse suspect?
Practice exercise (made-up values, not clinical guidance). A practice protocol calls for a heparin bolus of 60 units/kg for a patient who weighs 55 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 bag contains dobutamine 500 mg in 250 mL. The order is 5 mcg/kg/min for a patient who weighs 81 kg. At what rate R do you set the pump, 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 patient weighs 56 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 was started at 10:30 and runs by pump at 150 mL/h. How many mL V are left in the bag at 14:00?
Answer: A · To prevent accidental fluid overload
Infants and young children can quickly become fluid overloaded. Infusion pumps and burette (volume-control) sets limit how much fluid can run in, and the rate and site are checked regularly.
Answer: D · Splenic sequestration crisis, an emergency
In splenic sequestration, sickled cells are trapped in the spleen, which enlarges quickly while haemoglobin falls sharply, leading to shock. It needs urgent fluids and transfusion; parents are taught to feel the spleen and seek help.
Answer: V = 0.66 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 = 12.2 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.
Answer: U = 1.28 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: V = 475 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