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

A woman's cultural practice involves eating only warm foods after birth. How should the nurse respond?

  1. ATell her the practice is harmful and must stop
  2. BRespect it and offer suitable warm foods
  3. CInsist that she eat the standard hospital diet
  4. DIgnore her requests to save time
2.Maternity & obstetric nursingHard

A woman at 26 weeks has a haemoglobin of 95 g/L (9.5 g/dL) and a low ferritin. She is already taking oral iron but has severe side effects. What might be considered?

  1. AA routine blood transfusion
  2. BIntravenous iron
  3. CDoubling her caffeine intake
  4. DStopping iron and waiting until after birth
3.Dosage calculationsMedium
44 kgBSA = 1.33 m²375 mg/m²D = ? mg

A patient weighing 44 kg has a body surface area of 1.33 m². The prescription is 375 mg/m². Find the dose D in mg.

44 kgBSA = 1.33 m²375 mg/m²
D = mg
4.Dosage calculationsHard
10%stockV₁ = ? mL

You must prepare 200 mL of a 1% (w/v) solution from a 10% (w/v) stock solution. What volume of stock V₁ do you need?

C₁ = 10%C₂ = 1%V₂ = 200 mL
V₁ = mL
5.IV infusion ratesMedium
500 mL15 gtt/mL3 h? gtt/min

Infuse 500 mL over 3 hours with a giving set of 15 gtt/mL. Find the drip rate R in drops per minute. Round to the nearest whole number.

500 mL3 h15 gtt/mL
R = gtt/min
6.IV infusion ratesHard
1000 mg50 mL30 mL/h? mg/h

A bag contains 1000 mg of a drug in 50 mL and runs at 30 mL/h. How many milligrams per hour D does the patient receive?

1000 mg/50 mL30 mL/h
D = mg/h

3Solutions

1.Maternity & obstetric nursing

Answer: B · Respect it and offer suitable warm foods

Why this is the answer

Many cultures have postnatal dietary customs, such as warm foods. When a practice is not harmful, the nurse respects it and adapts care, which builds trust and supports recovery.

Answer

B · Respect it and offer suitable warm foods
2.Maternity & obstetric nursing

Answer: B · Intravenous iron

Why this is the answer

When oral iron is not tolerated or not effective, intravenous iron may be used in the second and third trimesters. Transfusion is reserved for severe or symptomatic anaemia or acute blood loss.

Answer

B · Intravenous iron
3.Dosage calculations

Answer: D = 498.8 mg

Body-surface-area dosing: many cytotoxic and some paediatric doses are prescribed per square metre of body surface area: dose (mg) = dose per m² × BSA (m²). The Mosteller formula estimates BSA = √(height (cm) × weight (kg)/3600).

Dose

D = 375·1.33 = 498.8 mg

Answer

D = 498.8 mg
4.Dosage calculations

Answer: V₁ = 20 mL

Solution strengths: a percentage strength is grams per 100 mL, so 1% = 1 g/100 mL = 10 mg/mL. A ratio strength 1:1000 means 1 g in 1000 mL = 1 mg/mL; 1:10 000 is 0.1 mg/mL. For a dilution the amount of drug stays the same: C₁·V₁ = C₂·V₂.

Volume of stock

V₁ = 1·200/10 = 20 mL

Answer

V₁ = 20 mL
5.IV infusion rates

Answer: R = 42 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 = 500·15/180 = 41.67 ≈ 42 gtt/min

Answer

R = 42 gtt/min

At the bedside you round to the nearest whole drop: 42 gtt/min.

6.IV infusion rates

Answer: D = 600 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

1000/50 = 20 mg/mL

Dose rate

D = 20·30 = 600 mg/h

Answer

D = 600 mg/h

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