Infection Prevention, Pharmacology, and Safe Medication Practice
Core concepts
Infection prevention requires standard precautions: hand hygiene (WHO's five moments), gloves, safe sharps disposal, sterile technique for invasive procedures, and decontamination and sterilization of equipment. Understand transmission-based precautions and post-exposure prophylaxis for HIV and hepatitis B. Pharmacology in midwifery includes oxytocin, misoprostol, magnesium sulfate, antibiotics, and antihypertensives. Know high-alert medications (oxytocin, magnesium, insulin) and the rights of medication administration (right patient, drug, dose, route, time, documentation). Learn common drug interactions and maternal-fetal considerations, plus safe storage and cold-chain for oxytocin.
Traps
Questions often test oxytocin administration rules: always dilute, use an infusion pump or controlled rate, and monitor uterine contractions and fetal heart rate - never give undiluted bolus. Another trap: confusing prophylactic versus therapeutic antibiotics and the timing of surgical prophylaxis (within 60 minutes before incision). Also watch hand hygiene moments - the fifth moment is after contact with the patient's surroundings, a frequent distractor.
Worked rule of thumb
Before giving any high-alert drug, use the two-identifier check and independent double-check for dose and rate. For oxytocin, verify concentration, rate, and contraction frequency; stop the infusion if contractions are too frequent (tachysystole).
Exam strategy
In medication error scenarios, the first action is assess the patient and stop the drug if harmful, then report through the incident system. Choose answers that reflect patient safety before documentation.