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. BFace-to-face eye contact and talking to the baby
  3. CAsking staff to keep the baby in the nursery at all times
  4. DCalling the baby "it" and not looking at it
2.Maternity & obstetric nursingHard

A woman at 40 weeks calls the unit. Her contractions are every 10 to 20 minutes and irregular, her membranes are intact and the baby is moving well. What is the best advice?

  1. ARest at home and come in if contractions become regular
  2. BLie flat on her back and count the contractions for 4 hours
  3. CTake a laxative to stimulate labour
  4. DCome in immediately by ambulance
3.Dosage calculationsMedium
70 kg10 mg/kgD = ? mg

A patient weighs 70 kg and is prescribed 10 mg/kg as a single dose. Find the dose D in mg.

70 kg10 mg/kg
D = mg
4.Dosage calculationsHard
200 mg/5 mLV = ? mL

A child weighing 24 kg is prescribed 12.5 mg/kg per dose of an oral suspension that contains 200 mg in 5 mL. What volume V do you give?

24 kg12.5 mg/kg200 mg/5 mL
V = mL
5.IV infusion ratesMedium
250 mL10 gtt/mL5 h? gtt/min

Infuse 250 mL over 5 hours with a giving set of 10 gtt/mL. Find the drip rate R in drops per minute. Round to the nearest whole number.

250 mL5 h10 gtt/mL
R = gtt/min
6.IV infusion ratesHard
450 mL15 gtt/mL42 gtt/mint = ? h

A drip runs at 42 gtt/min through a set of 15 gtt/mL. There are 450 mL left in the bag. How many hours t until it is empty? Round to one decimal place.

42 gtt/min15 gtt/mL450 mL
t = h

3Solutions

1.Maternity & obstetric nursing

Answer: B · 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

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

Answer: A · Rest at home and come in if contractions become regular

Why this is the answer

Irregular, infrequent contractions with intact membranes and good movements suggest early or false labour. She can rest at home and should come in if contractions become regular and stronger, the membranes rupture, she bleeds or movements decrease.

Answer

A · Rest at home and come in if contractions become regular
3.Dosage calculations

Answer: D = 700 mg

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.

Dose

10·70 = 700 mg

Answer

D = 700 mg
4.Dosage calculations

Answer: V = 7.5 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.

Dose from weight

12.5·24 = 300 mg

Volume

V = (300/200)·5 = 7.5 mL

Answer

V = 7.5 mL
5.IV infusion rates

Answer: R = 8 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

5·60 = 300 min

Drip rate

R = 250·10/300 = 8.333 ≈ 8 gtt/min

Answer

R = 8 gtt/min

At the bedside you round to the nearest whole drop: 8 gtt/min.

6.IV infusion rates

Answer: t = 2.7 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

42·60/15 = 168 mL/h

Time left

t = 450/168 = 2.679 ≈ 2.7 h

Answer

t = 2.7 h

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