Maternity Nursing: cram pack

Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.

New problemsBack to the course

In the print window, choose “Save as PDF” to keep a copy on your device.

1Formulas and methods

Maternity & obstetric nursing

Method

  1. Place the woman in time: weeks of pregnancy, stage of labour or day after birth, and decide what is normal at that point.
  2. Look for the patient in danger: the mother, the fetus or the newborn, or more than one of them.
  3. Link the finding to its cause: VEAL CHOP for decelerations, the four Ts for bleeding, BUBBLE-HE after birth.
  4. Choose the action that improves blood flow and oxygen first (side-lying, stopping oxytocin, fundal massage), then escalate.

Dosage calculations

Dose from strength
volume = dose / strength
Weight-based dose
dose = mg/kg × body weight
Tablets
number = dose / tablet strength
Units
1 g = 1000 mg, 1 mg = 1000 mcg

Method

  1. Convert the ordered dose and the stock strength to the same unit.
  2. Use desired over have times quantity: (D/H) × Q.
  3. For weight-based doses, multiply by the weight in kg first, then divide the daily dose by the number of doses.
  4. Estimate first and check that the answer is reasonable.

IV infusion rates

Pump rate
mL/h = volume (mL)/time (h)
Drip rate
drops/min = volume (mL) × drop factor / time (min)
Infusion time
time (h) = volume (mL)/rate (mL/h)

Method

  1. Pump rate in mL/h: volume divided by time in hours.
  2. Drip rate in drops/min: volume × drop factor divided by time in minutes.
  3. For time remaining: volume left divided by the rate.
  4. Round as the question or the equipment requires.

2Practice problems

1.Maternity & obstetric nursingMedium

A woman at 16 weeks has an amniocentesis. Which instruction after the procedure is correct?

  1. ABed rest is required for 2 weeks
  2. BDrink no fluids for 24 hours
  3. CReport fever, leaking fluid or bleeding
  4. DNo follow-up is needed for any symptoms
2.Maternity & obstetric nursingHard

A healthy newborn is jittery. Which finding helps tell jitteriness from a seizure?

  1. AJitteriness stops when the limb is gently held
  2. BSeizures are always triggered by loud sounds
  3. CJitteriness comes with eye deviation and apnoea
  4. DSeizures stop when the limb is held
3.Dosage calculationsMedium
25 kg25 mg/kg/day3× per dayD = ? mg

A patient weighs 25 kg. The prescribed dose is 25 mg/kg per day, given in 3 equal doses. How many milligrams D are given per dose?

25 kg25 mg/kg/day3× per day
D = mg
4.Dosage calculationsHard
00.10.20.30.40.50.60.70.80.911 mL

The prescription is 2880 micrograms. The ampoule contains 4 mg/mL. Draw up the dose in the 1 mL syringe: what volume V do you give?

2880 mcg4 mg/mL
V = mL
5.IV infusion ratesMedium
1000 mL15 gtt/mL3 h? gtt/min

Infuse 1000 mL over 3 hours with a giving set of 15 gtt/mL. Find the drip rate R in drops per minute. Round to the nearest whole number.

1000 mL3 h15 gtt/mL
R = gtt/min
6.IV infusion ratesHard
400 mL20 gtt/mL25 gtt/mint = ? h

A drip runs at 25 gtt/min through a set of 20 gtt/mL. There are 400 mL left in the bag. How many hours t until it is empty? Round to one decimal place.

25 gtt/min20 gtt/mL400 mL
t = h

3Solutions

1.Maternity & obstetric nursing

Answer: C · Report fever, leaking fluid or bleeding

Why this is the answer

After amniocentesis, she should report fever, leaking fluid, bleeding, severe cramps or reduced movements. Rh-negative women receive anti-D. Normal activity can usually resume soon.

Answer

C · Report fever, leaking fluid or bleeding
2.Maternity & obstetric nursing

Answer: A · Jitteriness stops when the limb is gently held

Why this is the answer

Jitteriness is a rhythmic tremor that is stimulus-sensitive and stops when the limb is held or flexed. Seizures continue when restrained and may include eye deviation, apnoea or lip smacking. Glucose and calcium are checked in both.

Answer

A · Jitteriness stops when the limb is gently held
3.Dosage calculations

Answer: D = 208.3 mg

Dose calculation: the amount to give equals what is prescribed divided by what you have, times the quantity it comes in: amount = (desired dose/stock strength) × stock volume. Always keep the units the same (convert g to mg, mg to mcg first) and check that the answer is sensible.

Total per day

25·25 = 625 mg

Per dose

D = 625/3 = 208.3 mg

Answer

D = 208.3 mg
4.Dosage calculations

Answer: V = 0.72 mL

Drawing up a dose: volume = (prescribed dose/stock strength) × stock volume. Convert to the same units first, then check that the volume fits the syringe and lands on one of its graduations.

Same units

4 mg/mL = 4000 mcg/mL

Volume

V = 2880/4000 = 0.72 mL

Answer

V = 0.72 mL
5.IV infusion rates

Answer: R = 83 gtt/min

Infusion rates: a pump is set in mL/h = volume/time in hours. A gravity drip is counted in drops per minute: gtt/min = volume (mL) × drop factor (gtt/mL)/time (min). The drop factor is printed on the tubing package: macrodrip sets deliver 10, 15 or 20 gtt/mL (blood sets often 10 gtt/mL in the US, 15 in the UK) and microdrip sets 60 gtt/mL. Always use the drop factor the question or package gives.

Time in minutes

3·60 = 180 min

Drip rate

R = 1000·15/180 = 83.33 ≈ 83 gtt/min

Answer

R = 83 gtt/min

At the bedside you round to the nearest whole drop: 83 gtt/min.

6.IV infusion rates

Answer: t = 5.3 h

Infusion rates: a pump is set in mL/h = volume/time in hours. A gravity drip is counted in drops per minute: gtt/min = volume (mL) × drop factor (gtt/mL)/time (min). The drop factor is printed on the tubing package: macrodrip sets deliver 10, 15 or 20 gtt/mL (blood sets often 10 gtt/mL in the US, 15 in the UK) and microdrip sets 60 gtt/mL. Always use the drop factor the question or package gives.

Rate in mL/h

25·60/20 = 75 mL/h

Time left

t = 400/75 = 5.333 ≈ 5.3 h

Answer

t = 5.3 h

ExamProblems · examproblems.com/courses/maternity-nursing