Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Which non-drug technique suits a 5-year-old during a cannula insertion?
A 9-month-old with suspected intussusception has been crying in episodes. While waiting for a procedure, the baby passes a normal brown stool and the pain stops. What should the nurse do?
Practice exercise (made-up values, not clinical guidance). A practice protocol calls for a heparin bolus of 60 units/kg for a patient who weighs 108 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 74 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 8-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 500 mL bag runs by pump at 60 mL/h. At 15:00, 250 mL have already been infused. How many hours t until the bag is empty? Round to one decimal place.
Answer: B · Blowing bubbles or looking at a pop-up book
Distraction that suits the child's age, such as bubbles, books, toys or videos, reduces pain and distress. Blowing bubbles also encourages slow, deep breathing. Parents are encouraged to stay and help.
Answer: B · Report it at once, because it may mean the intussusception has reduced
A normal stool may mean the intussusception has reduced by itself. The provider must be informed, because the planned procedure may change; the baby is still monitored for recurrence.
Answer: V = 6.5 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 = 22.2 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: I = 1420 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 = 4.2 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 4 h 10 min, so the bag runs out at about 19:10.
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