Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
A 13-year-old with scoliosis has been prescribed a brace. Which teaching is most important?
A 9-year-old with Down syndrome has new neck pain, clumsy walking and changes in bladder control. 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 69 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 dobutamine infusion of 500 mg in 250 mL runs at 10 mL/h. The patient weighs 93 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 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 500 mL bag runs by pump at 150 mL/h. At 15:30, 250 mL have already been infused. How many hours t until the bag is empty? Round to one decimal place.
Answer: D · Wear it for the prescribed hours each day, with a thin cotton shirt underneath
A brace can slow curve progression during growth only if it is worn for the prescribed time, often most of the day and night. A thin, seamless cotton layer protects the skin, which is checked daily for redness.
Answer: A · Atlantoaxial instability with spinal cord compression
Children with Down syndrome can have instability between the first two cervical vertebrae. Neck pain, changes in gait, weakness and bladder or bowel changes suggest cord compression and need urgent assessment.
Answer: V = 4.1 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 = 3.6 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: I = 1180 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: t = 1.7 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 1 h 40 min, so the bag runs out at about 17:10.
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