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

When is the nuchal translucency scan for first-trimester screening usually performed?

  1. AAt about 18 to 22 weeks
  2. BAt about 28 to 32 weeks
  3. CAt about 6 to 8 weeks
  4. DAt about 11 to 14 weeks
2.Maternity & obstetric nursingHard

Which statement by a pregnant woman with gestational diabetes shows she understands her care?

  1. A"My baby's growth will not need monitoring."
  2. B"I will check my glucose as shown and record it."
  3. C"I can skip meals if my glucose is high in the morning."
  4. D"Insulin will harm my baby, so I will refuse it."
3.Dosage calculationsMedium
024681010 mL

A child weighing 13 kg is prescribed 4 mg/kg of a drug. The stock solution contains 20 mg/mL. Draw up the dose: what volume V do you give?

13 kg4 mg/kg20 mg/mL
V = mL
4.Dosage calculationsHard
00.10.20.30.40.50.60.70.80.911 mL

The prescription is 1140 micrograms. The ampoule contains 2 mg/mL. Draw up the dose in the 1 mL syringe: what volume V do you give?

1140 mcg2 mg/mL
V = mL
5.IV infusion ratesMedium
500 mL10 gtt/mL3 h? gtt/min

Infuse 500 mL over 3 hours with a giving set of 10 gtt/mL. Find the drip rate R in drops per minute. Round to the nearest whole number.

500 mL3 h10 gtt/mL
R = gtt/min
6.IV infusion ratesHard
450 mL15 gtt/mL32 gtt/mint = ? h

A drip runs at 32 gtt/min through a set of 15 gtt/mL. There are 450 mL left in the bag. How many hours t until it is empty? Round to one decimal place.

32 gtt/min15 gtt/mL450 mL
t = h

3Solutions

1.Maternity & obstetric nursing

Answer: D · At about 11 to 14 weeks

Why this is the answer

Nuchal translucency is measured between about 11 and 14 weeks, often combined with blood markers. The detailed anatomy scan follows at about 18–22 weeks.

Answer

D · At about 11 to 14 weeks
2.Maternity & obstetric nursing

Answer: B · "I will check my glucose as shown and record it."

Why this is the answer

Regular glucose monitoring with records guides treatment changes. Skipping meals can cause hypoglycaemia and ketosis, insulin does not cross the placenta in a meaningful amount, and fetal growth is monitored.

Answer

B · "I will check my glucose as shown and record it."
3.Dosage calculations

Answer: V = 2.6 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 = 4·13 = 52 mg

Volume

V = 52/20 = 2.6 mL

On the syringe

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

Answer

V = 2.6 mL
4.Dosage calculations

Answer: V = 0.57 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

2 mg/mL = 2000 mcg/mL

Volume

V = 1140/2000 = 0.57 mL

Answer

V = 0.57 mL
5.IV infusion rates

Answer: R = 28 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 = 500·10/180 = 27.78 ≈ 28 gtt/min

Answer

R = 28 gtt/min

At the bedside you round to the nearest whole drop: 28 gtt/min.

6.IV infusion rates

Answer: t = 3.5 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

32·60/15 = 128 mL/h

Time left

t = 450/128 = 3.516 ≈ 3.5 h

Answer

t = 3.5 h

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