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

Which is a common sign of iron deficiency anaemia in pregnancy?

  1. ATiredness, pallor and breathlessness
  2. BWeight gain and ankle swelling
  3. CHigh blood pressure and headache
  4. DIncreased appetite and frequent urination
2.Maternity & obstetric nursingHard

A student nurse is caring for a newborn receiving phototherapy for jaundice. Which action requires correction?

  1. AApplying baby oil to the skin before the lights are switched on
  2. BChecking the baby's temperature and hydration regularly
  3. CCovering the baby's eyes with eye shields during phototherapy
  4. DRemoving the eye shields during feeds when the lights are off
3.Dosage calculationsMedium
024681010 mL

A child weighing 28 kg is prescribed 5 mg/kg of a drug. The stock solution contains 20 mg/mL. Draw up the dose: what volume V do you give?

28 kg5 mg/kg20 mg/mL
V = mL
4.Dosage calculationsHard
50k units500 mL? mL/h1500 units/h

An infusion contains 50000 units of a drug in 500 mL. The prescription is 1500 units per hour. At what rate R do you set the pump, in mL/h?

50000 units/500 mL1500 units/h
R = mL/h
5.IV infusion ratesMedium
10 gtt/mL30 mL/h? gtt/min

An infusion is ordered at 30 mL/h, but no pump is available. It runs by gravity through a giving set of 10 gtt/mL. Find the drip rate R in drops per minute.

30 mL/h10 gtt/mL
R = gtt/min
6.IV infusion ratesHard
750 mL20 gtt/mL42 gtt/mint = ? h

A drip runs at 42 gtt/min through a set of 20 gtt/mL. There are 750 mL left in the bag. How many hours t until it is empty? Round to one decimal place.

42 gtt/min20 gtt/mL750 mL
t = h

3Solutions

1.Maternity & obstetric nursing

Answer: A · Tiredness, pallor and breathlessness

Why this is the answer

Iron deficiency causes fatigue, pallor, breathlessness, palpitations and sometimes pica. A full blood count and ferritin confirm the diagnosis.

Answer

A · Tiredness, pallor and breathlessness
2.Maternity & obstetric nursing

Answer: A · Applying baby oil to the skin before the lights are switched on

Why this is the answer

Oils and lotions can cause burns under phototherapy lights and should not be applied. Eye shields protect the retina, temperature and hydration are monitored because of increased fluid loss, and feeds are an opportunity for eye contact without the shields.

Answer

A · Applying baby oil to the skin before the lights are switched on
3.Dosage calculations

Answer: V = 7 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 = 5·28 = 140 mg

Volume

V = 140/20 = 7 mL

On the syringe

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

Answer

V = 7 mL
4.Dosage calculations

Answer: R = 15 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

50000/500 = 100 units/mL

Pump rate

R = 1500/100 = 15 mL/h

Answer

R = 15 mL/h
5.IV infusion rates

Answer: R = 5 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.

Millilitres per minute

30/60 = 0.5 mL/min

Drip rate

R = 0.5·10 = 5 gtt/min

Answer

R = 5 gtt/min
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

42·60/20 = 126 mL/h

Time left

t = 750/126 = 5.952 ≈ 6 h

Answer

t = 6 h

ExamProblems · examproblems.com/courses/maternity-nursing