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 do newborns become cold so easily?

  1. AThey have a large surface area and little fat
  2. BThey cannot produce heat at all
  3. CThey sweat more than adults
  4. DTheir blood is thicker than adult blood
2.Maternity & obstetric nursingHard

One hour after birth, the large baby of a mother with diabetes is jittery and feeding poorly. What should the nurse do first?

  1. ACheck the baby's blood glucose
  2. BWrap the baby tightly and recheck in 4 hours
  3. CGive a bath to wake the baby up
  4. DReassure the parents that jitteriness is normal
3.Dosage calculationsMedium
500 mg+ 1.8 mLV = ? mL

A vial contains 500 mg of powder. The label says: add 1.8 mL of water for injection to give a total volume of 2 mL. The prescription is 300 mg. What volume V of the reconstituted solution do you give?

500 mg+ 1.8 mL → 2 mL300 mg
V = mL
4.Dosage calculationsHard
00.10.20.30.40.50.60.70.80.911 mL

The prescription is 7600 units of a drug that comes as 10000 units/mL. Draw up the dose in the 1 mL syringe: what volume V do you give?

7600 units10000 units/mL
V = mL
5.IV infusion ratesMedium
V = ?60 gtt/mL30 gtt/min3 h

A drip runs at 30 gtt/min through a set of 60 gtt/mL. How many millilitres V does the patient receive in 3 hours?

30 gtt/min60 gtt/mL3 h
V = mL
6.IV infusion ratesHard
200 mg100 mL25 mL/h? mg/h

A bag contains 200 mg of a drug in 100 mL and runs at 25 mL/h. How many milligrams per hour D does the patient receive?

200 mg/100 mL25 mL/h
D = mg/h

3Solutions

1.Maternity & obstetric nursing

Answer: A · They have a large surface area and little fat

Why this is the answer

Newborns have a large surface area relative to body mass, little subcutaneous fat and thin skin with blood vessels near the surface. They rely on brown fat and cannot shiver effectively.

Answer

A · They have a large surface area and little fat
2.Maternity & obstetric nursing

Answer: A · Check the baby's blood glucose

Why this is the answer

Jitteriness and poor feeding in a high-risk newborn suggest hypoglycaemia. A point-of-care glucose check guides treatment, such as feeding or glucose gel per protocol, with escalation if the level stays low.

Answer

A · Check the baby's blood glucose
3.Dosage calculations

Answer: V = 1.2 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.

Concentration after mixing

500 mg/2 mL = 250 mg/mL

Volume

V = 300/250 = 1.2 mL

Answer

V = 1.2 mL
4.Dosage calculations

Answer: V = 0.76 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 = 7600/10000 = 0.76 mL

On the syringe

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

Answer

V = 0.76 mL
5.IV infusion rates

Answer: V = 90 mL

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

30·60/60 = 30 mL/h

Volume

V = 30·3 = 90 mL

Answer

V = 90 mL
6.IV infusion rates

Answer: D = 50 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 = 2·25 = 50 mg/h

Answer

D = 50 mg/h

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