Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
An infant with heart failure is treated with furosemide. Which blood result is most important to monitor?
A 4-year-old has a high fever, is drooling, sitting forward with the neck extended and looks anxious. What should the nurse do first?
Practice exercise (made-up values, not clinical guidance). A bag contains 25 000 units of heparin in 500 mL. The order is 12 units/kg/h for a patient who weighs 52 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 patient who weighs 91 kg has an order for nitroglycerin at 10 mcg/min. The bag contains 25 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 patient weighs 86 kg. Find the average urine output U in mL/kg/h. Round to two decimal places.
Practice exercise (made-up values, not clinical guidance). A 1000 mL infusion starts at 12:00 at 125 mL/h. After 2 hours the rate is changed to 80 mL/h and is not changed again. How many hours t after the start will the bag be empty? Round to one decimal place.
Answer: A · Serum potassium
Furosemide causes loss of potassium in the urine. Low potassium can cause arrhythmias and increases the risk of digoxin toxicity, so potassium is checked regularly.
Answer: A · Keep the child calm and upright with the parent, and call a team skilled in airway management
These signs suggest epiglottitis or another upper airway emergency. Avoid distressing interventions, keep the child in their position of comfort and get expert airway help immediately.
Answer: R = 12.5 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 = 6 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: U = 1.26 mL/kg/h
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 = 11.4 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 23 min, so the bag runs out at about 23:23.
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