Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Which drink is best for a child with mild dehydration from gastroenteritis?
A 5-year-old with leukaemia tells the nurse she is ill because she was naughty. What is the best response?
Practice exercise (made-up values, not clinical guidance). An infusion contains 100 units of regular insulin in 250 mL. The order is 6 units/h. 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 82 kg has an order for nitroglycerin at 15 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 8-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 125 mL/h. At 14:00, 100 mL have already been infused. How many hours t until the bag is empty? Round to one decimal place.
Answer: A · Oral rehydration solution
Oral rehydration solution has the right balance of sodium and glucose to promote water absorption. Juice, fizzy drinks and many sports drinks contain too much sugar and too little sodium and can worsen diarrhoea.
Answer: C · Reassure her clearly that nothing she did or thought made her ill
Preoperational children use magical thinking and may believe illness is a punishment for bad behaviour or thoughts. Clear, repeated reassurance in simple language reduces guilt and fear.
Answer: R = 15 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 = 4.5 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 = 7.2 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 7 h 12 min, so the bag runs out at about 21:12.
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