Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
A child with type 1 diabetes is unconscious from hypoglycaemia at school. What should be done?
A 6-year-old boy has had a limp and mild hip pain for several weeks. Imaging shows avascular necrosis of the femoral head. What is the diagnosis?
Practice exercise (made-up values, not clinical guidance). A bag contains 10 000 units of heparin in 250 mL. The order is 15 units/kg/h for a patient who weighs 59 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). A patient who weighs 57 kg has an order for norepinephrine at 5 mcg/min. The bag contains 4 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 12-hour shift. The IV infusion ran at the rate shown for the whole shift. Find the total intake I in mL. Count ice chips as half their volume.
Practice exercise (made-up values, not clinical guidance). A 1000 mL infusion starts at 08:00 at 100 mL/h. After 4 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: B · Give glucagon and call emergency services
An unconscious child cannot swallow safely, so glucagon is given by injection or nasal spray, the child is placed in the recovery position and emergency help is called. Once awake and able to swallow, carbohydrate is given.
Answer: A · Legg–Calvé–Perthes disease
Perthes disease is avascular necrosis of the femoral head in children, most often boys aged about 4–8 years. It presents with a limp and hip, thigh or knee pain; treatment aims to keep the femoral head well positioned in the socket while it heals.
Answer: R = 22.1 mL/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: R = 18.8 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 = 1240 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 = 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 7 h 00 min, so the bag runs out at about 15:00.
ExamProblems · examproblems.com/courses/pediatric-nursing