Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
A child with a known egg allergy is due for an influenza vaccine. Which statement reflects most current guidance?
The parent of a child on chemotherapy calls to say the child has a temperature of 38.5 °C (101.3 °F). What is the correct advice?
Practice exercise (made-up values, not clinical guidance). An infusion contains 50 units of regular insulin in 50 mL. The order is 0.1 units/kg/h for a patient who weighs 63 kg. Find the pump rate R in mL/h. Round to one decimal place.
Practice exercise (made-up values, not clinical guidance). A bag contains dopamine 800 mg in 500 mL. The order is 4 mcg/kg/min for a patient who weighs 82 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). Count ice chips as half their volume.
Practice exercise (made-up values, not clinical guidance). A 1000 mL bag was started at 13:15 and runs by pump at 150 mL/h. How many mL V are left in the bag at 17:15?
Answer: B · Egg allergy alone is generally no longer a reason to withhold influenza vaccination
Guidance in many countries now states that children with egg allergy can receive influenza vaccines in routine settings, because the ovalbumin content is very low. Follow the current national guidance for specific cases.
Answer: D · Bring the child to hospital straight away for assessment and IV antibiotics
Fever during chemotherapy is treated as possible neutropenic sepsis. The child needs urgent assessment, blood tests and cultures, and IV antibiotics within the target time set by local policy; delay can be fatal.
Answer: R = 6.3 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.
Answer: R = 12.3 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 = −335 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.
Negative: the patient lost more fluid than went in.
Answer: V = 400 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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