Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Which group of findings suggests Kawasaki disease?
A 4-year-old has had pallor, tiredness, bruising, bone pain and fevers for 3 weeks. What is the most important next step?
Practice exercise (made-up values, not clinical guidance). A practice protocol calls for a heparin bolus of 70 units/kg for a patient who weighs 49 kg. The vial contains 5 000 units/mL. What volume V do you draw up? Round to two decimal places.
Practice exercise (made-up values, not clinical guidance). A bag contains dopamine 400 mg in 250 mL. The order is 10 mcg/kg/min 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). The record shows a patient's intake and output for one 8-hour shift. The patient weighs 63 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 75 mL/h. At 21:30, 100 mL have already been infused. How many hours t until the bag is empty? Round to one decimal place.
Answer: A · Fever for at least 5 days, red eyes without discharge, cracked red lips and swollen hands and feet
Kawasaki disease causes persistent fever plus features such as non-purulent conjunctivitis, red cracked lips and strawberry tongue, rash, swollen hands and feet and enlarged neck lymph nodes. The other options describe croup, chickenpox and roseola.
Answer: C · An urgent full blood count to look for leukaemia
Pallor (low red cells), bruising (low platelets), infections or fever (abnormal white cells) and bone pain from marrow expansion together suggest leukaemia. An urgent full blood count and blood film are needed.
Answer: V = 0.69 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 = 22.9 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 = 1.69 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 = 5.3 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 5 h 20 min, so the bag runs out at about 02:50.
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