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. CIgnore her requests to save time
  4. DInsist that she eat the standard hospital diet
2.Maternity & obstetric nursingHard

A woman at 9 weeks has hCG levels that are much higher than expected, a uterus large for dates, severe vomiting and dark brown spotting. Which condition should be suspected?

  1. AA missed miscarriage
  2. BAn ectopic pregnancy
  3. CA hydatidiform (molar) pregnancy
  4. DA threatened miscarriage
3.Dosage calculationsMedium
024681010 mL

A child weighing 16 kg is prescribed 4 mg/kg of a drug. The stock solution contains 40 mg/mL. Draw up the dose: what volume V do you give?

16 kg4 mg/kg40 mg/mL
V = mL
4.Dosage calculationsHard
00.10.20.30.40.50.60.70.80.911 mL

The prescription is 3350 units of a drug that comes as 5000 units/mL. Draw up the dose in the 1 mL syringe: what volume V do you give?

3350 units5000 units/mL
V = mL
5.IV infusion ratesMedium
1000 mL20 gtt/mL10 h? gtt/min

Infuse 1000 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.

1000 mL10 h20 gtt/mL
R = gtt/min
6.IV infusion ratesHard
1000 mg500 mL60 gtt/mL80 mg/h? gtt/min

1000 mg of a drug is diluted in 500 mL and given by gravity through a set of 60 gtt/mL. The order is 80 mg per hour. Find the drip rate R in drops per minute.

1000 mg/500 mL80 mg/h60 gtt/mL
R = gtt/min

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: C · A hydatidiform (molar) pregnancy

Why this is the answer

A molar pregnancy causes very high hCG, a uterus larger than dates, hyperemesis and bleeding. Ectopic and failing pregnancies usually have lower than expected hCG.

Answer

C · A hydatidiform (molar) pregnancy
3.Dosage calculations

Answer: V = 1.6 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 = 4·16 = 64 mg

Volume

V = 64/40 = 1.6 mL

On the syringe

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

Answer

V = 1.6 mL
4.Dosage calculations

Answer: V = 0.67 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 = 3350/5000 = 0.67 mL

On the syringe

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

Answer

V = 0.67 mL
5.IV infusion rates

Answer: R = 33 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 = 1000·20/600 = 33.33 ≈ 33 gtt/min

Answer

R = 33 gtt/min

At the bedside you round to the nearest whole drop: 33 gtt/min.

6.IV infusion rates

Answer: R = 40 gtt/min

Dose-based infusions: concentration = amount of drug in the bag/bag volume. Pump rate (mL/h) = dose per hour/concentration, and dose per hour = mL/h × concentration. Convert per-minute doses to per-hour (× 60) and keep the mass units the same (1 g = 1000 mg, 1 mg = 1000 mcg).

Concentration

1000/500 = 2 mg/mL

Volume per hour

80/2 = 40 mL/h

Drip rate

R = 40·60/60 = 40 gtt/min

Answer

R = 40 gtt/min

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