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

Why is the hearing of newborns screened before discharge or soon after birth?

  1. AEarly support improves language development
  2. BIt detects congenital heart disease
  3. CHearing loss can be cured with a single injection
  4. DIt is required before vitamin K can be given
2.Maternity & obstetric nursingHard

Which statement by a woman being discharged after birth shows a need for further teaching?

  1. A"I should call if my bleeding gets heavier or smells bad."
  2. B"I can use tampons for the bleeding as soon as I get home."
  3. C"I should change my pads regularly and wash my hands."
  4. D"I should report a painful, swollen calf straight away."
3.Dosage calculationsMedium
024681010 mL

A child weighing 12 kg is prescribed 10 mg/kg of a drug. The stock solution contains 50 mg/mL. Draw up the dose: what volume V do you give?

12 kg10 mg/kg50 mg/mL
V = mL
4.Dosage calculationsHard
00.10.20.30.40.50.60.70.80.911 mL

The prescription is 420 units of a drug that comes as 1000 units/mL. Draw up the dose in the 1 mL syringe: what volume V do you give?

420 units1000 units/mL
V = mL
5.IV infusion ratesMedium
300 mLleft? mL/h3 h left

1000 mL was ordered over 12 hours. After 9 hours you find that 300 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?

1000 mL / 12 hafter 9 h: 300 mL
R = mL/h
6.IV infusion ratesHard
400 mL60 gtt/mL42 gtt/mint = ? h

A drip runs at 42 gtt/min through a set of 60 gtt/mL. There are 400 mL left in the bag. How many hours t until it is empty? Round to one decimal place.

42 gtt/min60 gtt/mL400 mL
t = h

3Solutions

1.Maternity & obstetric nursing

Answer: A · Early support improves language development

Why this is the answer

Early detection of hearing loss allows hearing aids, cochlear implants or other support in the first months, which greatly improves language outcomes.

Answer

A · Early support improves language development
2.Maternity & obstetric nursing

Answer: B · "I can use tampons for the bleeding as soon as I get home."

Why this is the answer

Tampons are avoided until lochia has stopped and the postnatal check is done, because they increase the risk of infection. The other statements are correct.

Answer

B · "I can use tampons for the bleeding as soon as I get home."
3.Dosage calculations

Answer: V = 2.4 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.

Dose from body weight

D = 10·12 = 120 mg

Volume

V = 120/50 = 2.4 mL

On the syringe

On this 10 mL syringe every small line is 0.2 mL.

Answer

V = 2.4 mL
4.Dosage calculations

Answer: V = 0.42 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.

Volume

V = 420/1000 = 0.42 mL

On the syringe

On this 1 mL syringe every small line is 0.01 mL.

Answer

V = 0.42 mL
5.IV infusion rates

Answer: R = 100 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

1000/12 = 83.33 mL/h

New rate

R = 300/3 = 100 mL/h

Answer

R = 100 mL/h

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

6.IV infusion rates

Answer: t = 9.5 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

42·60/60 = 42 mL/h

Time left

t = 400/42 = 9.524 ≈ 9.5 h

Answer

t = 9.5 h

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