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

Which behaviour shows positive early bonding between mother and newborn?

  1. AAvoiding holding the baby during the first day
  2. BAsking staff to keep the baby in the nursery at all times
  3. CFace-to-face eye contact and talking to the baby
  4. DCalling the baby "it" and not looking at it
2.Maternity & obstetric nursingHard

A woman at 28 weeks has itching, and her liver tests and bile acids are raised. Which advice is most important?

  1. ATake a hot bath to relieve the itching
  2. BStop attending antenatal visits once itching settles
  3. CReport reduced fetal movements straight away
  4. DItching proves the baby is healthy
3.Dosage calculationsMedium
0.5%w/vV = ? mL

A dose of 12.5 mg is needed from a 0.5% (w/v) solution. What volume V contains this dose?

12.5 mg0.5% w/v
V = mL
4.Dosage calculationsHard
56 kg164 cmBSA = √(h·w/3600)250 mg/m²D = ? mg

A patient is 164 cm tall and weighs 56 kg. The prescription is 250 mg/m². Using the Mosteller formula BSA = √(height (cm) × weight (kg)/3600), find the dose D in mg.

164 cm56 kg250 mg/m²
D = mg
5.IV infusion ratesMedium
1340 mLleft? mL/h8 h left

1500 mL was ordered over 10 hours. After 2 hours you find that 1340 mL is still in the bag, and the order must still finish on time. To what rate R in mL/h must the pump be reset?

1500 mL / 10 hafter 2 h: 1340 mL
R = mL/h
6.IV infusion ratesHard
600 mL15 gtt/mL25 gtt/mint = ? h

A drip runs at 25 gtt/min through a set of 15 gtt/mL. There are 600 mL left in the bag. How many hours t until it is empty?

25 gtt/min15 gtt/mL600 mL
t = h

3Solutions

1.Maternity & obstetric nursing

Answer: C · Face-to-face eye contact and talking to the baby

Why this is the answer

En face positioning, touching, talking in a high-pitched voice and calling the baby by name are positive bonding behaviours. Persistent avoidance needs further assessment and support.

Answer

C · Face-to-face eye contact and talking to the baby
2.Maternity & obstetric nursing

Answer: C · Report reduced fetal movements straight away

Why this is the answer

Intrahepatic cholestasis is linked with stillbirth, especially with high bile acids. Women are monitored closely, told to report reduced movements and may be offered birth earlier. Cool baths and emollients ease itching.

Answer

C · Report reduced fetal movements straight away
3.Dosage calculations

Answer: V = 2.5 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.

Concentration

0.5% = 5 mg/mL

Volume

V = 12.5/5 = 2.5 mL

Answer

V = 2.5 mL
4.Dosage calculations

Answer: D = 399.3 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).

Body surface area

BSA = √(164·56/3600) = √2.551 = 1.597 m²

Dose

D = 250·1.597 = 399.3 mg

Answer

D = 399.3 mg
5.IV infusion rates

Answer: R = 167.5 mL/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.

Original rate

1500/10 = 150 mL/h

New rate

R = 1340/8 = 167.5 mL/h

Answer

R = 167.5 mL/h

Many hospitals allow such an adjustment up to 25% without a new order; check local policy.

6.IV infusion rates

Answer: t = 6 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

25·60/15 = 100 mL/h

Time left

t = 600/100 = 6 h

Answer

t = 6 h

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