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 in late pregnancy has numbness and tingling in her thumb and first fingers, worse at night. What is the most likely cause?

  1. ALow blood calcium
  2. BA stroke caused by pre-eclampsia
  3. CCarpal tunnel syndrome
  4. DVitamin K deficiency
2.Maternity & obstetric nursingHard

The partner of a woman receiving magnesium sulfate asks what the drug is for. Which answer is accurate?

  1. AIt is the main drug that lowers her blood pressure
  2. BIt speeds up labour
  3. CIt helps prevent seizures caused by pre-eclampsia
  4. DIt stops the baby from growing too large
3.Dosage calculationsMedium
30 kg15 mg/kg/day2× per dayD = ? mg

A patient weighs 30 kg. The prescribed dose is 15 mg/kg per day, given in 2 equal doses. How many milligrams D are given per dose?

30 kg15 mg/kg/day2× per day
D = mg
4.Dosage calculationsHard
50k units1000 mL? mL/h1500 units/h

An infusion contains 50000 units of a drug in 1000 mL. The prescription is 1500 units per hour. At what rate R do you set the pump, in mL/h?

50000 units/1000 mL1500 units/h
R = mL/h
5.IV infusion ratesMedium
500 mL15 gtt/mL4 h? gtt/min

Infuse 500 mL over 4 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 mL4 h15 gtt/mL
R = gtt/min
6.IV infusion ratesHard
600 mL15 gtt/mL30 gtt/mint = ? h

A drip runs at 30 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?

30 gtt/min15 gtt/mL600 mL
t = h

3Solutions

1.Maternity & obstetric nursing

Answer: C · Carpal tunnel syndrome

Why this is the answer

Fluid retention in pregnancy can compress the median nerve in the carpal tunnel. A wrist splint at night often helps, and symptoms usually resolve after birth.

Answer

C · Carpal tunnel syndrome
2.Maternity & obstetric nursing

Answer: C · It helps prevent seizures caused by pre-eclampsia

Why this is the answer

Magnesium sulfate is given to prevent and treat eclamptic seizures. It is not an effective antihypertensive, so severe hypertension needs separate drugs.

Answer

C · It helps prevent seizures caused by pre-eclampsia
3.Dosage calculations

Answer: D = 225 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.

Total per day

15·30 = 450 mg

Per dose

D = 450/2 = 225 mg

Answer

D = 225 mg
4.Dosage calculations

Answer: R = 30 mL/h

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

50000/1000 = 50 units/mL

Pump rate

R = 1500/50 = 30 mL/h

Answer

R = 30 mL/h
5.IV infusion rates

Answer: R = 31 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

4·60 = 240 min

Drip rate

R = 500·15/240 = 31.25 ≈ 31 gtt/min

Answer

R = 31 gtt/min

At the bedside you round to the nearest whole drop: 31 gtt/min.

6.IV infusion rates

Answer: t = 5 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

30·60/15 = 120 mL/h

Time left

t = 600/120 = 5 h

Answer

t = 5 h

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