Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
A 16-year-old starts an SSRI antidepressant. What is especially important to monitor in the first weeks?
A 6-year-old is prescribed codeine for pain after a tonsillectomy. What should the nurse do?
Practice exercise (made-up values, not clinical guidance). A practice protocol calls for a heparin bolus of 80 units/kg for a patient who weighs 83 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 500 mg in 250 mL. The order is 2.5 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 patient weighs 52 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 bag was started at 13:00 and runs by pump at 75 mL/h. How many mL V are left in the bag at 14:00?
Answer: C · Worsening mood or new suicidal thoughts
Antidepressants may be linked to increased suicidal thinking in some young people, especially early in treatment or after dose changes. Close follow-up, safety planning and involving the family are advised.
Answer: B · Question the order with the prescriber before giving it
Codeine is contraindicated in children under 12 and after tonsillectomy or adenoidectomy in children under 18, because of fatal respiratory depression in ultra-rapid metabolisers. The nurse should question the order.
Answer: V = 6.6 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 = 5.6 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.
Answer: U = 1.5 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: V = 925 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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