Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Which signs in a 2-day-old baby suggest sepsis?
A toddler weighed 10 kg before 2 days of diarrhoea and now weighs 9.5 kg. How much has he lost?
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 97 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 bag contains dopamine 400 mg in 250 mL. The order is 15 mcg/kg/min for a patient who weighs 81 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 12-hour shift. The patient weighs 100 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 500 mL bag runs by pump at 150 mL/h. At 10:00, 150 mL have already been infused. How many hours t until the bag is empty? Round to one decimal place.
Answer: D · Unstable temperature, poor feeding, lethargy and breathing difficulty
Neonatal sepsis may present with temperature instability, poor feeding, lethargy, irritability, apnoea, breathing difficulty or jaundice. Early-onset sepsis, often due to group B streptococcus, needs prompt cultures and IV antibiotics.
Answer: C · 500 g, about 5% of his body weight, mostly fluid
10 kg − 9.5 kg = 0.5 kg; 0.5 ÷ 10 = 5%. Rapid weight loss during acute illness is mostly fluid, so it is a useful measure of the degree of dehydration, alongside clinical signs.
Answer: R = 29.1 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 = 45.6 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 = 0.4 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 = 2.3 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 2 h 20 min, so the bag runs out at about 12:20.
ExamProblems · examproblems.com/courses/pediatric-nursing