Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
What is "assent" in children's care?
A family insists on staying with their child during a painful procedure. What is the most appropriate response in family-centred care?
Practice exercise (made-up values, not clinical guidance). A bag contains 20 000 units of heparin in 500 mL. The order is 12 units/kg/h for a patient who weighs 99 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 57 kg has an order for norepinephrine at 6 mcg/min. The bag contains 8 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 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).
Practice exercise (made-up values, not clinical guidance). A 500 mL infusion starts at 19:30 at 120 mL/h. After 2 hours the rate is changed to 75 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: C · The child's agreement to care, sought alongside the parents' consent
Assent is the child's own agreement, in language suited to their age, alongside the legal consent given by parents. Seeking assent respects the child and builds cooperation and trust.
Answer: B · Support their presence, prepare them for what they will see and give them a comforting role
Family presence during procedures is supported in family-centred care. Prepare parents, give them a role such as holding or distracting the child, and let them choose whether to stay.
Answer: R = 29.7 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 = 11.3 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: B = 505 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: t = 5.5 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 5 h 28 min, so the bag runs out at about 00:58.
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