Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Which signs suggest hypoglycaemia in a young child with diabetes?
A 4-year-old says it is wrong to hit his sister "because then I get a time-out". Which level of Kohlberg's moral development does this reflect?
Practice exercise (made-up values, not clinical guidance). An infusion contains 50 units of regular insulin in 50 mL. The order is 0.05 units/kg/h for a patient who weighs 62 kg. Find the pump rate R in mL/h. Round to one decimal place.
Practice exercise (made-up values, not clinical guidance). A patient who weighs 59 kg has an order for nitroglycerin at 10 mcg/min. The bag contains 50 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 12-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 runs by pump at 80 mL/h. At 15:00, 50 mL have already been infused. How many hours t until the bag is empty? Round to one decimal place.
Answer: C · Shakiness, sweating, pallor and a sudden change in behaviour
Hypoglycaemia causes adrenergic signs (shaking, sweating, pallor, fast heart rate) and neuroglycopenic signs (irritability, confusion, unusual behaviour, drowsiness). Young children may not recognise or report it.
Answer: D · Preconventional level
At the preconventional level, typical of young children, right and wrong are judged by punishment and reward. Formal operational is one of Piaget's cognitive stages, not a Kohlberg level.
Answer: R = 3.1 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 = 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.
The order is per minute for the whole patient, so the weight is not needed.
Answer: I = 1170 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 = 11.9 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 11 h 53 min, so the bag runs out at about 02:53.
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