Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
In a large ventricular septal defect, in which direction does blood mainly flow through the defect?
A 9-year-old is being treated for an acute asthma attack. Which finding shows that treatment is working?
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 52 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 dopamine infusion of 400 mg in 250 mL runs at 18 mL/h. The patient weighs 62 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 8-hour shift. The IV infusion ran at the rate shown for the whole shift. Find the total intake I in mL.
Practice exercise (made-up values, not clinical guidance). A 1000 mL bag was started at 09:45 and runs by pump at 150 mL/h. How many mL V are left in the bag at 11:45?
Answer: C · From left to right, increasing blood flow to the lungs
Left ventricular pressure is higher, so blood flows from left to right, overloading the lungs and right heart. This causes increased pulmonary blood flow and can lead to heart failure in infancy.
Answer: C · Slower breathing, easier speech and less use of the neck and chest muscles
Improvement shows as a lower respiratory rate, easier speech, less accessory muscle use and better oxygen saturation. A quiet chest with drowsiness signals exhaustion and danger, and tripod positioning shows ongoing distress.
Answer: V = 0.73 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: D = 7.7 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: I = 1150 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: V = 700 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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