Maternity Nursing: cram pack

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

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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's cultural practice involves eating only warm foods after birth. How should the nurse respond?

  1. ARespect it and offer suitable warm foods
  2. BTell her the practice is harmful and must stop
  3. CIgnore her requests to save time
  4. DInsist that she eat the standard hospital diet
2.Maternity & obstetric nursingHard

Routine screening at the booking visit shows asymptomatic bacteriuria. Why is treatment important even though the woman has no symptoms?

  1. ATreatment is not needed because it will settle after birth
  2. BIt will cause gestational diabetes later in the pregnancy if left untreated
  3. CIt is treated only to prevent bladder stones
  4. DIt can progress to pyelonephritis and trigger preterm labour
3.Dosage calculationsMedium
51 kgBSA = 1.36 m²175 mg/m²D = ? mg

A patient weighing 51 kg has a body surface area of 1.36 m². The prescription is 175 mg/m². Find the dose D in mg.

51 kgBSA = 1.36 m²175 mg/m²
D = mg
4.Dosage calculationsHard
40 mg/1 mLV = ? mL

A child weighing 16 kg is prescribed 15 mg/kg per dose of an oral suspension that contains 40 mg in 1 mL. What volume V do you give?

16 kg15 mg/kg40 mg/1 mL
V = mL
5.IV infusion ratesMedium
1400 mLleft? mL/h6 h left

1500 mL was ordered over 8 hours. After 2 hours you find that 1400 mL is still in the bag, and the order must still finish on time. To what rate R in mL/h must the pump be reset?

1500 mL / 8 hafter 2 h: 1400 mL
R = mL/h
6.IV infusion ratesHard
25 mg250 mL15 mL/h? mcg/min

An infusion of 25 mg in 250 mL runs at 15 mL/h. How many micrograms per minute D does the patient receive?

25 mg/250 mL15 mL/h
D = mcg/min

3Solutions

1.Maternity & obstetric nursing

Answer: A · Respect it and offer suitable warm foods

Why this is the answer

Many cultures have postnatal dietary customs, such as warm foods. When a practice is not harmful, the nurse respects it and adapts care, which builds trust and supports recovery.

Answer

A · Respect it and offer suitable warm foods
2.Maternity & obstetric nursing

Answer: D · It can progress to pyelonephritis and trigger preterm labour

Why this is the answer

Urinary stasis in pregnancy lets bacteria ascend, so untreated bacteriuria often progresses to pyelonephritis, which is linked with preterm labour. A pregnancy-safe antibiotic and a repeat culture are standard.

Answer

D · It can progress to pyelonephritis and trigger preterm labour
3.Dosage calculations

Answer: D = 238 mg

Body-surface-area dosing: many cytotoxic and some paediatric doses are prescribed per square metre of body surface area: dose (mg) = dose per m² × BSA (m²). The Mosteller formula estimates BSA = √(height (cm) × weight (kg)/3600).

Dose

D = 175·1.36 = 238 mg

Answer

D = 238 mg
4.Dosage calculations

Answer: V = 6 mL

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.

Dose from weight

15·16 = 240 mg

Volume

V = (240/40)·1 = 6 mL

Answer

V = 6 mL
5.IV infusion rates

Answer: R = 233.3 mL/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.

Original rate

1500/8 = 187.5 mL/h

New rate

R = 1400/6 = 233.3 mL/h

Answer

R = 233.3 mL/h

Many hospitals allow such an adjustment up to 25% without a new order; check local policy.

6.IV infusion rates

Answer: D = 25 mcg/min

Dose-based infusions: concentration = amount of drug in the bag/bag volume. Pump rate (mL/h) = dose per hour/concentration, and dose per hour = mL/h × concentration. Convert per-minute doses to per-hour (× 60) and keep the mass units the same (1 g = 1000 mg, 1 mg = 1000 mcg).

Concentration

25000 mcg/250 mL = 100 mcg/mL

Dose per hour

15·100 = 1500 mcg/h

Dose per minute

D = 1500/60 = 25 mcg/min

Answer

D = 25 mcg/min

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