Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Which activity best supports a 9-year-old during a long hospital stay?
In England, a 15-year-old asks a nurse for contraception and does not want her parents told. Which principle applies?
Practice exercise (made-up values, not clinical guidance). A practice protocol calls for a heparin bolus of 80 units/kg for a patient who weighs 70 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 bag contains dobutamine 250 mg in 250 mL. The order is 5 mcg/kg/min for a patient who weighs 96 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 12-hour shift. The IV infusion ran at the rate shown for the whole shift. Find the fluid balance B = intake − output in mL (a negative answer means a net loss).
Practice exercise (made-up values, not clinical guidance). A 500 mL bag was started at 09:45 and runs by pump at 120 mL/h. How many mL V are left in the bag at 12:15?
Answer: B · Schoolwork and contact with classmates, plus games or hobbies
School-age children need to feel competent and connected. Hospital school, contact with friends and age-appropriate games, crafts and collections support Erikson's task of industry and reduce feelings of isolation.
Answer: C · She may consent herself if judged competent (Gillick and Fraser)
Under the Gillick case and Fraser guidelines, a young person under 16 who understands the treatment and its implications can consent to contraception. Staff encourage involving parents and assess for any safeguarding concerns.
Answer: V = 5.6 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 = 28.8 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.
Answer: B = 605 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.
Positive: more fluid went in than came out.
Answer: V = 200 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.
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