产科护理
方法
- 把产妇放在时间轴上定位：孕周、产程阶段或产后第几天，再判断此时什么是正常的。
- 找出处于危险中的对象：母亲、胎儿或新生儿，或者其中不止一个。
- 把发现与其原因联系起来：减速用 VEAL CHOP，出血用四个 T，产后用 BUBBLE-HE。
- 优先选择改善血流和氧合的措施（侧卧、停用缩宫素、宫底按摩），然后再升级处理。
产科护理：速成包
公式表、每个专题的关键方法步骤和 6 道练习题，完整解答附在最后。
1公式与方法
剂量计算
- 由浓度计算剂量
- 体积 = 剂量 / 浓度
- 按体重给药
- 剂量 = mg/kg × 体重
- 片剂
- 片数 = 剂量 / 每片规格
- 单位
- 1 g = 1000 mg, 1 mg = 1000 mcg
方法
- 把医嘱剂量和药品规格换算为同一单位。
- 用“需要量除以现有量再乘以数量”：(D/H) × Q。
- 按体重给药时，先乘以以 kg 计的体重，再用日剂量除以给药次数。
- 先估算，再检查答案是否合理。
静脉输液速度
- 泵速
- mL/h = volume (mL)/time (h)
- 滴速
- drops/min = volume (mL) × drop factor / time (min)
- 输注时间
- time (h) = volume (mL)/rate (mL/h)
方法
- 泵速 mL/h：体积除以以小时计的时间。
- 滴速 drops/min：体积 × 滴系数，再除以以分钟计的时间。
- 剩余时间：剩余体积除以速率。
- 按题目或设备的要求取整。
2练习题
1.产科护理中等
Parents ask where their newborn should sleep at night. Which advice reduces the risk of sudden infant death?
- AIn a separate bedroom from the first night
- BOn a sofa with a parent when the baby is unsettled
- CIn the parents' bed, between the two adults
- DIn a separate cot or crib in the parents' room
2.产科护理困难
Which statement by a woman with postnatal depression shows that the nurse's teaching has been effective?
- A"If I take medicine I can never breastfeed again."
- B"I will tell my midwife or doctor if I have thoughts of harming myself."
- C"I should keep my feelings to myself so I don't worry my family."
- D"Depression after birth means I am a bad mother."
3.剂量计算中等
需要从 0.5%（w/v）溶液中取 5 mg 的剂量。多少容量 V 含有这一剂量？
5 mg0.5% w/v
V = mL
4.剂量计算困难
一名体重 18 kg 的儿童，医嘱为口服混悬液每次 10 mg/kg，该混悬液每 5 mL 含 250 mg。你应给多少体积 V？
18 kg10 mg/kg250 mg/5 mL
V = mL
5.静脉输液速度中等
医嘱要求在 8 小时内输入 1000 mL。3 小时后你发现袋中还剩 780 mL，而输液仍须按时完成。 必须把泵重新设定为多少 mL/h 的速率 R？
1000 mL / 8 h经过 3 h: 780 mL
R = mL/h
6.静脉输液速度困难
200 mg 药物溶于 250 mL 的输液以 5 mL/h 运行。患者每分钟接受多少微克 D？
200 mg/250 mL5 mL/h
D = mcg/min
3溶液
1.产科护理
答案: D · In a separate cot or crib in the parents' room
为什么是这个答案
Both US (AAP) and UK (NHS) guidance advise room-sharing without bed-sharing: the baby sleeps on the back in a cot or crib in the parents' room for at least the first 6 months. Sleeping with a baby on a sofa or armchair is especially dangerous.
答案
D · In a separate cot or crib in the parents' room
2.产科护理
答案: B · "I will tell my midwife or doctor if I have thoughts of harming myself."
为什么是这个答案
Teaching aims to reduce shame, encourage support and make clear that thoughts of self-harm must be reported urgently. Many antidepressants are compatible with breastfeeding, and depression is a treatable illness, not a failure.
答案
B · "I will tell my midwife or doctor if I have thoughts of harming myself."
3.剂量计算
答案: V = 1 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.
浓度
0.5% = 5 mg/mL
体积
V = 5/5 = 1 mL
答案
V = 1 mL
4.剂量计算
答案: V = 3.6 mL
剂量计算：给药量等于医嘱剂量除以现有药物的规格，再乘以该规格对应的量：给药量 = (医嘱剂量/储备规格) × 储备体积。始终统一单位（先把 g 换成 mg，mg 换成 mcg），并检查答案是否合理。
按体重计算剂量
10·18 = 180 mg
体积
V = (180/250)·5 = 3.6 mL
答案
V = 3.6 mL
5.静脉输液速度
答案: R = 156 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.
原速率
1000/8 = 125 mL/h
新速率
R = 780/5 = 156 mL/h
答案
R = 156 mL/h
许多医院允许在不重开医嘱的情况下进行不超过 25% 的此类调整；请查阅本院规定。
6.静脉输液速度
答案: D = 66.67 mcg/min
Dose-based infusions: concentration = amount of drug in the bag/bag volume. Pump rate (mL/h) = dose per hour/concentration, and dose per hour = mL/h × concentration. Convert per-minute doses to per-hour (× 60) and keep the mass units the same (1 g = 1000 mg, 1 mg = 1000 mcg).
浓度
200000 mcg/250 mL = 800 mcg/mL
每小时剂量
5·800 = 4000 mcg/h
每分钟剂量
D = 4000/60 = 66.67 mcg/min
答案
D = 66.67 mcg/min
ExamProblems · examproblems.com/courses/maternity-nursing