Pediatric Nursing: cram pack

Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.

New problemsBack to the course

In the print window, choose “Save as PDF” to keep a copy on your device.

1Formulas and methods

Pediatric nursing

Method

  1. Note the child’s age first: it sets the normal vital signs, the milestones and the right pain scale.
  2. Assess airway, breathing and circulation, remembering that children compensate and then deteriorate fast.
  3. Match the action to the development stage and involve the family.
  4. Check that the answer is safe for a child: weight-based, no aspirin in viral illness, no codeine under 12.

Pediatric & critical-care dosing

Daily dose
mg/day = mg/kg/day × weight (kg)
Doses per day
number = 24 h / dosing interval (h)
Pounds to kilograms
kg = lb / 2.2
Infusion concentration
units/mL = units in bag / bag volume
Pump rate
mL/h = dose per hour / concentration
Titrated drip
mL/h = mcg/kg/min × kg × 60 / (mcg/mL)
Dose from pump rate
mcg/kg/min = mL/h × (mcg/mL) / (60 × kg)
Units
1 mg = 1000 mcg

IV fluids & fluid balance

Holliday–Segar per hour
4 mL/kg (first 10 kg) + 2 mL/kg (next 10 kg) + 1 mL/kg (each kg above 20)
Holliday–Segar per day
100 / 50 / 20 mL/kg for the same bands
Fluid balance
intake − output
Ice chips
count as half their volume
Urine output
mL/kg/h = mL / (kg × h)
Infusion time
time (h) = volume left (mL) / rate (mL/h)
Volume infused
mL = rate × time

2Practice problems

1.Pediatric nursingMedium

Why should a child with rubella avoid contact with pregnant women?

  1. AThe child may catch a pregnancy-related infection
  2. BRubella in early pregnancy can cause serious birth defects
  3. CRubella causes pregnant women to go into labour early
  4. DPregnant women always develop severe pneumonia if they catch rubella
2.Pediatric nursingHard

The nurse has taught a parent about treating head lice. Which statement shows a need for further teaching?

  1. A"Lice can spread when children's heads touch."
  2. B"I'll use a fine-toothed comb on wet hair to find lice."
  3. C"After one treatment, I won't need to check her hair again."
  4. D"I'll check everyone else in the family for lice as well."
3.Pediatric & critical-care dosingMedium
20 000 units500 mLheparin? mL/h100 kg20 units/kg/h

Practice exercise (made-up values, not clinical guidance). A bag contains 20 000 units of heparin in 500 mL. The order is 20 units/kg/h for a patient who weighs 100 kg. At what rate R do you set the pump, in mL/h? Round to one decimal place.

20 000 units/500 mL20 units/kg/h100 kg
R = mL/h
4.Pediatric & critical-care dosingHard
800 mg500 mLdopamine? mL/h67 kg10 mcg/kg/min

Practice exercise (made-up values, not clinical guidance). A bag contains dopamine 800 mg in 500 mL. The order is 10 mcg/kg/min for a patient who weighs 67 kg. At what rate R do you set the pump, in mL/h? Round to one decimal place.

800 mg/500 mL10 mcg/kg/min67 kg
R = mL/h
5.IV fluids & fluid balanceMedium
IntakeOutput12-hour shiftmilk200 mLtea200 mLice chips100 mLIV infusion50 mL/h × 12 hIV antibiotic1 × 50 mLurine400 mLurine300 mLurine150 mLwound drain140 mLvomit100 mL

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.

milk: 200 mLtea: 200 mLice chips: 100 mLIV infusion: 50 mL/h × 12 hIV antibiotic: 1 × 50 mL
I = mL
6.IV fluids & fluid balanceHard
500 mL150 mL infused125 mL/h12:30t = ? h

Practice exercise (made-up values, not clinical guidance). A 500 mL bag runs by pump at 125 mL/h. At 12:30, 150 mL have already been infused. How many hours t until the bag is empty? Round to one decimal place.

500 mL150 mL infused125 mL/h
t = h

3Solutions

1.Pediatric nursing

Answer: B · Rubella in early pregnancy can cause serious birth defects

Why this is the answer

Congenital rubella syndrome can cause deafness, eye defects such as cataracts, heart defects and developmental problems, especially when infection occurs early in pregnancy. MMR vaccination protects against this.

Answer

B · Rubella in early pregnancy can cause serious birth defects
2.Pediatric nursing

Answer: C · "After one treatment, I won't need to check her hair again."

Why this is the answer

Many treatments do not kill all eggs, so a second application or repeated wet combing over about two weeks is usually needed, with checks afterwards. Checking family members and wet combing are correct.

Answer

C · "After one treatment, I won't need to check her hair again."
3.Pediatric & critical-care dosing

Answer: R = 50 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.

Units per hour

20·100 = 2 000 units/h

Concentration

20 000/500 = 40 units/mL

Pump rate

R = 2000/40 = 50 mL/h

Answer

R = 50 mL/h
4.Pediatric & critical-care dosing

Answer: R = 25.1 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.

Concentration

800 mg = 800 000 mcg
800 000/500 = 1600 mcg/mL

Dose per minute and per hour

10·67 = 670 mcg/min
670·60 = 40200 mcg/h

Pump rate

R = 40200/1600 = 25.13 ≈ 25.1 mL/h

Answer

R = 25.1 mL/h
5.IV fluids & fluid balance

Answer: I = 1100 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.

Add the intake

oral: 200 + 200 = 400 mL
ice chips: 100/2 = 50 mL
IV infusion: 50·12 = 600 mL
IV antibiotic: 1·50 = 50 mL
I = 1100 mL

Answer

I = 1100 mL
6.IV fluids & fluid balance

Answer: t = 2.8 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.

Volume left

500 − 150 = 350 mL

Time

t = 350/125 = 2.8 h

Answer

t = 2.8 h

That is about 2 h 48 min, so the bag runs out at about 15:18.

ExamProblems · examproblems.com/courses/pediatric-nursing