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?
A child with a new forearm cast has severe pain not relieved by analgesia and screams when the nurse gently moves the fingers. What should the nurse suspect?
Practice exercise (made-up values, not clinical guidance). A practice protocol calls for a heparin bolus of 70 units/kg for a patient who weighs 65 kg. The vial contains 5 000 units/mL. What volume V do you draw up? Round to two decimal places.
Practice exercise (made-up values, not clinical guidance). A patient who weighs 76 kg has an order for nitroglycerin at 30 mcg/min. The bag contains 25 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 8-hour shift. The patient weighs 81 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 was started at 13:30 and runs by pump at 100 mL/h. How many mL V are left in the bag at 15:30?
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: A · Compartment syndrome; report it at once
Rising pressure within a muscle compartment cuts off blood supply. Severe pain unrelieved by analgesia and pain on passive movement are early signs; pulselessness is late. The prescriber is told immediately, the limb is not elevated above heart level and the cast may need splitting.
Answer: V = 0.91 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 = 18 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: U = 2.01 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: V = 300 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.
ExamProblems · examproblems.com/courses/pediatric-nursing