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 labouring woman's tracing shows variable decelerations. Which action should the nurse take first?

  1. APlace her flat on her back
  2. BStart pushing efforts straight away
  3. CChange the woman's position
  4. DIncrease the oxytocin infusion
2.Maternity & obstetric nursingHard

A newborn has a deep dimple with a tuft of hair over the lower spine. What is the significance?

  1. AIt means the baby will have hip dysplasia
  2. BIt is an expected birthmark with no meaning
  3. CIt is a sign of congenital heart disease
  4. DIt may be a sign of an underlying spinal defect
3.Dosage calculationsMedium
024681010 mL

A child weighing 30 kg is prescribed 2 mg/kg of a drug. The stock solution contains 20 mg/mL. Draw up the dose: what volume V do you give?

30 kg2 mg/kg20 mg/mL
V = mL
4.Dosage calculationsHard
25k units1000 mL? mL/h2000 units/h

An infusion contains 25000 units of a drug in 1000 mL. The prescription is 2000 units per hour. At what rate R do you set the pump, in mL/h?

25000 units/1000 mL2000 units/h
R = mL/h
5.IV infusion ratesMedium
250 mL60 gtt/mL10 h? gtt/min

Infuse 250 mL over 10 hours with a giving set of 60 gtt/mL. Find the drip rate R in drops per minute.

250 mL10 h60 gtt/mL
R = gtt/min
6.IV infusion ratesHard
200 mg100 mL30 mL/h? mg/h

A bag contains 200 mg of a drug in 100 mL and runs at 30 mL/h. How many milligrams per hour D does the patient receive?

200 mg/100 mL30 mL/h
D = mg/h

3Solutions

1.Maternity & obstetric nursing

Answer: C · Change the woman's position

Why this is the answer

Repositioning (side to side, or hands and knees) often relieves cord compression. If the decelerations persist, the provider is notified. Lying flat adds caval compression.

Answer

C · Change the woman's position
2.Maternity & obstetric nursing

Answer: D · It may be a sign of an underlying spinal defect

Why this is the answer

A sacral dimple with a hair tuft, swelling or skin change may indicate spina bifida occulta or a tethered cord. It should be reported, and spinal ultrasound is often arranged.

Answer

D · It may be a sign of an underlying spinal defect
3.Dosage calculations

Answer: V = 3 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 = 2·30 = 60 mg

Volume

V = 60/20 = 3 mL

On the syringe

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

Answer

V = 3 mL
4.Dosage calculations

Answer: R = 80 mL/h

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.

Concentration

25000/1000 = 25 units/mL

Pump rate

R = 2000/25 = 80 mL/h

Answer

R = 80 mL/h
5.IV infusion rates

Answer: R = 25 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

10·60 = 600 min

Drip rate

R = 250·60/600 = 25 gtt/min

Answer

R = 25 gtt/min
6.IV infusion rates

Answer: D = 60 mg/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.

Concentration

200/100 = 2 mg/mL

Dose rate

D = 2·30 = 60 mg/h

Answer

D = 60 mg/h

ExamProblems · examproblems.com/courses/maternity-nursing