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

A woman has painful haemorrhoids after a vaginal birth. Which measure is appropriate?

  1. AAvoiding all fluids to prevent loose stools
  2. BStraining hard to open the bowels
  3. CSitting on a hard surface for long periods
  4. DSitz baths, cold pads and stool softeners
2.Maternity & obstetric nursingHard

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

  1. APlan early support and monitoring before and after birth
  2. BTell her that breastfeeding will prevent it
  3. CAdvise her that it will not happen again
  4. DWait to see whether depression returns after birth
3.Dosage calculationsMedium
2 g+ 7.4 mLV = ? mL

A vial contains 2 g of powder. The label says: add 7.4 mL of water for injection to give a total volume of 8 mL. The prescription is 300 mg. What volume V of the reconstituted solution do you give?

2 g+ 7.4 mL → 8 mL300 mg
V = mL
4.Dosage calculationsHard
00.10.20.30.40.50.60.70.80.911 mL

The prescription is 140 units of a drug that comes as 1000 units/mL. Draw up the dose in the 1 mL syringe: what volume V do you give?

140 units1000 units/mL
V = mL
5.IV infusion ratesMedium
500 mL60 gtt/mL10 h? gtt/min

Infuse 500 mL over 10 hours with a giving set of 60 gtt/mL. Find the drip rate R in drops per minute.

500 mL10 h60 gtt/mL
R = gtt/min
6.IV infusion ratesHard
300 mL20 gtt/mL50 gtt/mint = ? h

A drip runs at 50 gtt/min through a set of 20 gtt/mL. There are 300 mL left in the bag. How many hours t until it is empty?

50 gtt/min20 gtt/mL300 mL
t = h

3Solutions

1.Maternity & obstetric nursing

Answer: D · Sitz baths, cold pads and stool softeners

Why this is the answer

Sitz baths, cold or witch hazel pads, topical treatments, fluids, fibre and stool softeners reduce pain and prevent constipation and straining.

Answer

D · Sitz baths, cold pads and stool softeners
2.Maternity & obstetric nursing

Answer: A · 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

A · Plan early support and monitoring before and after birth
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

2000 mg/8 mL = 250 mg/mL

Volume

V = 300/250 = 1.2 mL

Answer

V = 1.2 mL
4.Dosage calculations

Answer: V = 0.14 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 = 140/1000 = 0.14 mL

On the syringe

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

Answer

V = 0.14 mL
5.IV infusion rates

Answer: R = 50 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 = 500·60/600 = 50 gtt/min

Answer

R = 50 gtt/min
6.IV infusion rates

Answer: t = 2 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

50·60/20 = 150 mL/h

Time left

t = 300/150 = 2 h

Answer

t = 2 h

ExamProblems · examproblems.com/courses/maternity-nursing