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

When the Moro reflex is tested, the baby moves only one arm. What could this suggest?

  1. AA normal finding in all term babies
  2. BHearing loss in the ear on that side
  3. CA clavicle fracture or nerve injury
  4. DLow blood glucose only
2.Maternity & obstetric nursingHard

A woman with a history of postnatal depression is pregnant again. What is the most appropriate plan?

  1. AAdvise her that it will not happen again
  2. BWait to see whether depression returns after birth
  3. CTell her that breastfeeding will prevent it
  4. DPlan early support and monitoring before and after birth
3.Dosage calculationsMedium
024681010 mL

A child weighing 30 kg is prescribed 3 mg/kg of a drug. The stock solution contains 50 mg/mL. Draw up the dose: what volume V do you give?

30 kg3 mg/kg50 mg/mL
V = mL
4.Dosage calculationsHard
40 mg/1 mLV = ? mL

A patient weighs 61.6 lb. The prescription is 0.5 mg/kg as a single dose, and the stock contains 40 mg in 1 mL. Using 1 kg = 2.2 lb, what volume V do you give?

61.6 lb0.5 mg/kg40 mg/1 mL1 kg = 2.2 lb
V = mL
5.IV infusion ratesMedium
10 gtt/mL30 mL/h? gtt/min

An infusion is ordered at 30 mL/h, but no pump is available. It runs by gravity through a giving set of 10 gtt/mL. Find the drip rate R in drops per minute.

30 mL/h10 gtt/mL
R = gtt/min
6.IV infusion ratesHard
200 mL15 gtt/mL28 gtt/mint = ? h

A drip runs at 28 gtt/min through a set of 15 gtt/mL. There are 200 mL left in the bag. How many hours t until it is empty? Round to one decimal place.

28 gtt/min15 gtt/mL200 mL
t = h

3Solutions

1.Maternity & obstetric nursing

Answer: C · A clavicle fracture or nerve injury

Why this is the answer

The Moro reflex should be bilateral and symmetrical. An absent response on one side suggests clavicle fracture or brachial plexus palsy, both linked with shoulder dystocia and large babies.

Answer

C · A clavicle fracture or nerve injury
2.Maternity & obstetric nursing

Answer: D · Plan early support and monitoring before and after birth

Why this is the answer

A past episode increases the risk of recurrence. Early identification, a care plan with mental health services, support and monitoring during pregnancy and after birth are recommended.

Answer

D · Plan early support and monitoring before and after birth
3.Dosage calculations

Answer: V = 1.8 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 = 3·30 = 90 mg

Volume

V = 90/50 = 1.8 mL

On the syringe

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

Answer

V = 1.8 mL
4.Dosage calculations

Answer: V = 0.35 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.

Weight in kg

61.6/2.2 = 28 kg

Dose

0.5·28 = 14 mg

Volume

V = (14/40)·1 = 0.35 mL

Answer

V = 0.35 mL
5.IV infusion rates

Answer: R = 5 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.

Millilitres per minute

30/60 = 0.5 mL/min

Drip rate

R = 0.5·10 = 5 gtt/min

Answer

R = 5 gtt/min
6.IV infusion rates

Answer: t = 1.8 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

28·60/15 = 112 mL/h

Time left

t = 200/112 = 1.786 ≈ 1.8 h

Answer

t = 1.8 h

ExamProblems · examproblems.com/courses/maternity-nursing