Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Which is a true contraindication to a further dose of the same vaccine?
A 9-year-old is being treated for an acute asthma attack. Which finding shows that treatment is working?
Practice exercise (made-up values, not clinical guidance). A bag contains 12 500 units of heparin in 250 mL. The order is 15 units/kg/h for a patient who weighs 61 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 dopamine infusion of 400 mg in 250 mL runs at 4 mL/h. The patient weighs 82 kg. What dose D in mcg/kg/min is the patient receiving? 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 500 mL bag runs by pump at 120 mL/h. At 09:30, 300 mL have already been infused. How many hours t until the bag is empty? Round to one decimal place.
Answer: A · Anaphylaxis after a previous dose of that vaccine
A severe allergic reaction to a previous dose or to a vaccine component is a contraindication. Local redness and mild fever are common, expected reactions.
Answer: C · Slower breathing, easier speech and less use of the neck and chest muscles
Improvement shows as a lower respiratory rate, easier speech, less accessory muscle use and better oxygen saturation. A quiet chest with drowsiness signals exhaustion and danger, and tripod positioning shows ongoing distress.
Answer: R = 18.3 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: D = 1.3 mcg/kg/min
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: I = 980 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 = 1.7 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 1 h 40 min, so the bag runs out at about 11:10.
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