Midwifery exemptions Questions and Answers

Midwifery exemptions Questions and Answers What is a midwifery exemption? Medication that can be administered or supplied by a midwife to women under their care under their own autonomy and knowledge of the situation of the patient What should be considered before giving medication? 5Rs - right patient, right drug, right dose, right route, right time Any allergies or contraindications Checking with another midwife (expiry) Whats the calculation for medicine dosage? What you want / what you've got x what its in What is the dosage for ferrous sulphate? 200mg 2-3x daily What is ferrous sulphate used for? Anaemia (hb110) What are the contraindications for ferrous sulphate? Stomach ulcers, Hb110 What are the side effects of ferrous sulphate? Constipation, loss of appetite, nausea What is the dose of pethidine? 50-100mg IM What is the purpose of pethidine? Pain relief in labour (4cm) When should the next dose of pethidine be given? 4 hourly What are the contraindications for pethidine? Respiratory disease (asthma) Birth is imminent (crosses placenta to baby in small amounts) What are the side effects of pethidine VOMITING (given with an anti-emetic), confusion, dry mouth, hypotension What is the dose of lactulose? 15ml BD oral Whats the contraindication for lactulose? Caution with diabetes What are the side effects to lactulose? Diarrhoea and bloating What is the dose of dihydrocodeine? 10mg PO What is a caution with administering dihydrocodeine? Opiod users (dependance) Seizures Asthma What are the side effects to dihydrocodeine? Constipation, sickness, dry mouth What is the dose of lidocaine hydrochloride? Up to 20ml What is the purpose of lidocaine? Perineal local anaesthetic for episiotomy or perineal repair What are the contraindications for lidocaine? Heart problems, nil need for episiotomy or perineal repair What are the side effects of lidocaine? Drowsiness, dizziness, temperature changes What is the purpose of anti-D immunoglobulin Prevention of HDN How does HDN occur? Occurs when maternal rhesus neg blood is sensitised to rhesus pos blood and generates antibodies What is HDN? hemolytic disease of the newborn What is the dose of Anti-D? 1500 units, given at 28/40 and after delivery if rhesus statuses dont match after blood test What are the contraindications to Anti-D? Matching rhesus status What are the side effects of anti-D? Fever, skin irritation, nausea What are the side effects of paracetamol? Liver damage, low blood pressure, increased heart rate What is the purpose of paracetamol? Analgesia in labour, postnatally, iol or mtop What is the purpose of oxytocin (syntocinon) Contraction of the uterus to induce labour What are the side effects of oxytocin? Tachycardia, hyper stimulation Whats an example of a patient group directive? Benzylpenicilin What is the dose of benzylpenicilin 1.5/3g IV What is the purpose of benzylpenicilin Prophylaxis against infection (SROM 18 hours) and GBS Contraindications to benpen Allergy to penicilin Side effects to benzylpenicilin Nausea vomitting muscle pain