Infection Prevention, Pharmacology, and Safe Medication Practice
Infection Prevention, Pharmacology, and Safe Medication Practice
This domain tests standard precautions, sharps safety, post-exposure management, and safe use of the drugs midwives give most: oxytocin, magnesium sulfate, antibiotics, misoprostol, tranexamic acid, and antihypertensives. Calculation accuracy and high-alert checks are examinable.
Core rules
- Hand hygiene before and after patient contact; use gloves for body fluids; never recap needles; dispose of sharps immediately.
- Sterilise reusable instruments by autoclave or approved method; separate clean and dirty flow; decontaminate spills.
- Five rights: right patient, drug, dose, route, time; add documentation and reason. Double-check high-alert drugs and calculations. Label all syringes and never leave high-alert drugs unattended.
- Oxytocin: never give undiluted IV bolus; dilute and infuse per protocol. Magnesium sulfate: check renal function, reflexes, respiration, and urine output.
- Post-exposure: wash, report immediately, and start HIV PEP within 72 hours, ideally within 2 hours.
Worked example
You need 4 g of magnesium sulfate from a 50% solution. Reasoning: 50% = 500 mg/mL, so 4 g = 4000 mg ÷ 500 mg/mL = 8 mL. Dilute in the prescribed diluent and give IV slowly per protocol; label the syringe and document.
Traps
Decimal-point errors; confusing 50% with 5%; giving oxytocin IV push; omitting renal monitoring with magnesium; and recapping needles.