Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Which advice is first-line for a school-age child with functional constipation?
A toddler weighed 10 kg before 2 days of diarrhoea and now weighs 9.5 kg. How much has he lost?
Practice exercise (made-up values, not clinical guidance). An infusion of 250 units of regular insulin in 250 mL runs at 10 mL/h. How many units per hour D does the patient receive?
Practice exercise (made-up values, not clinical guidance). A dobutamine infusion of 500 mg in 250 mL runs at 21 mL/h. The patient weighs 81 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 105 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 500 mL bag runs by pump at 60 mL/h. At 07:00, 200 mL have already been infused. How many hours t until the bag is empty? Round to one decimal place.
Answer: C · More fibre and fluids, a regular toilet time after meals and laxatives if prescribed
Management of functional constipation combines diet (fibre, fluids), regular unhurried toilet sitting after meals, praise-based behaviour support and prescribed laxatives. Withholding stool at school worsens it.
Answer: A · 500 g, about 5% of his body weight, mostly fluid
10 kg − 9.5 kg = 0.5 kg; 0.5 ÷ 10 = 5%. Rapid weight loss during acute illness is mostly fluid, so it is a useful measure of the degree of dehydration, alongside clinical signs.
Answer: D = 10 units/h
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 = 8.6 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: U = 0.67 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 = 5 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 5 h 00 min, so the bag runs out at about 12:00.
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