Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
On abdominal palpation at 39 weeks, only 2/5 of the fetal head can be felt above the pelvic brim. How is this interpreted?
A newborn whose mother had a fever and prolonged rupture of membranes is well at birth. Why does the nurse monitor this baby closely?
A child weighing 20 kg is prescribed 2.5 mg/kg of a drug. The stock solution contains 25 mg/mL. Draw up the dose: what volume V do you give?
An infusion contains 20000 units of a drug in 250 mL. The prescription is 1250 units per hour. At what rate R do you set the pump, in mL/h?
Infuse 250 mL over 10 hours with a giving set of 20 gtt/mL. Find the drip rate R in drops per minute. Round to the nearest whole number.
A bag contains 1000 mg of a drug in 250 mL and runs at 25 mL/h. How many milligrams per hour D does the patient receive?
Answer: C · The head is engaged in the pelvis
Descent can be described in fifths of the head palpable above the brim. When 2/5 or less can be felt, the widest part of the head has passed the inlet, so it is engaged; 5/5 palpable means the head is free. Many US units describe descent mainly by station on vaginal examination instead.
Answer: A · The baby has a higher risk of early sepsis
Maternal fever, prolonged rupture of membranes and intra-amniotic infection are risk factors for early-onset sepsis. Many protocols require observation of vital signs and feeding, and sometimes blood tests or antibiotics.
Answer: V = 2 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.
On this 10 mL syringe every small line is 0.2 mL.
Answer: R = 15.63 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.
Answer: R = 8 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.
At the bedside you round to the nearest whole drop: 8 gtt/min.
Answer: D = 100 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.
ExamProblems · examproblems.com/courses/maternity-nursing