Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
In a child with hypovolaemic shock, which finding is usually a late sign?
Which finding in a 3-month-old with bronchiolitis requires immediate follow-up?
Practice exercise (made-up values, not clinical guidance). A bag contains 12 500 units of heparin in 250 mL. The order is 18 units/kg/h for a patient who weighs 108 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 5 mcg/kg/min for a patient who weighs 106 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 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 1000 mL bag runs by pump at 80 mL/h. At 15:30, 300 mL have already been infused. How many hours t until the bag is empty? Round to one decimal place.
Answer: D · Low blood pressure
Children maintain blood pressure through vasoconstriction and tachycardia until a large volume is lost. Hypotension means decompensated shock and impending collapse.
Answer: A · Pauses in breathing (apnoea) and an oxygen saturation of 88%
Apnoea and low oxygen saturation are signs of severe bronchiolitis and need urgent assessment and support. The other findings are typical of mild bronchiolitis.
Answer: R = 38.9 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 = 19.9 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: B = −280 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.
Negative: the patient lost more fluid than went in.
Answer: t = 8.8 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 8 h 45 min, so the bag runs out at about 00:15.
ExamProblems · examproblems.com/courses/pediatric-nursing