Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Why is hearing screening done in the newborn period?
A 3-year-old was pulled from a pool after a brief submersion. She is now awake and coughs now and then. What should the nurse advise?
Practice exercise (made-up values, not clinical guidance). A bag contains 20 000 units of heparin in 500 mL. The order is 16 units/kg/h for a patient who weighs 58 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). A dobutamine infusion of 250 mg in 250 mL runs at 28 mL/h. The patient weighs 107 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 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 07:45 and runs by pump at 100 mL/h. How many mL V are left in the bag at 15:15?
Answer: C · Early detection allows support that protects language development
Permanent hearing loss is often not obvious in babies. Screening allows diagnosis and support, such as hearing aids, within the first months, which greatly improves speech and language outcomes.
Answer: C · Observe her in hospital for several hours, as breathing problems can develop later
After a drowning incident, even a child who seems well can develop worsening breathing difficulty and low oxygen over the following hours. Children who had symptoms such as coughing need medical assessment and a period of observation.
Answer: R = 23.2 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: D = 4.4 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: B = 755 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.
Positive: more fluid went in than came out.
Answer: V = 250 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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