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You also agree to not distribute or share these materials under any circumstances; they are for personal use only. © 2021 NurseInTheMaking LLC. All content is property of NurseInTheMaking LLC and www.anurseinthemaking.com. Replication and distribution of this material is prohibited by law. All digital products (PDF files, ebooks, resources, and all online content) are subject to copyright protection. Each product sold is licensed to an individual user and customers are not allowed to distribute, copy, share, or transfer the products to any other individual or entity, they are for personal use only. Fines of up to $10,000 may apply and individuals will be reported to the BRN and their school of nursing. Medsurg clinicals cheat sheet normal vital signs Blood Pressure (bp) Systolic Diastolic Heart Rate (hr) 60 – 100 bpm Respiratory rate (rr) Parenteral Administration 120 mmHg 80 mmHg angle * 12 – 20 breaths/min temperature (t) 97.8 – 99°F (36.5 - 37.2°C) oxygen (o2) 95 – 100% COPD pts are expected to have lower O2 levels * PRO TIP: Intradermal (ID) 10 - 15° Subcutaneous (SUBQ) Normal/overweight: 90° Thin: 45° Abdomen • Posterior upper arm • Thigh Intramuscular (IM) 90° Deltoid • Vastus lateralis • Ventrogluteal Intravenous (IV) 25° Hand • Wrist Cubital fossa • Foot • Scalp Electrolytes <135 NA+ 135 – 145 mEq/L <3.5 Thready, weak, irregular pulse, anxiety K+ 3.5 – 5.0 mEq/L PHOS 2.5 – 4.5 mg/dL >5.0 Muscle weakness and cramps <2.5 Change of LOC, numbness, weakening of the bones >4.5 Diarrhea, Muscle weakness, ↓DTR 9 – 11 mg/dL MG+ 1.5 – 2.5 mg/dL <1.5 Increased everything (↑BP, ↑HR, ↑RR, ↑DTR) BASIC METABOLIC PANEL (BMP) K 3.5 - 5 WBC 4.5 - 11 x103 HCO3 Cr 22 - 26 0.6 - 1.2 Glucose 70 - 100 COAGULATION PT 10 - 13 sec INR 1-2 PTT 25 - 35 sec CBC LIVER PANEL Hgb F: 12 - 16 M: 13 - 18 Total Bilirubin 0.1 - 1.2 HCT F: 36% - 48% M: 39% - 54% PLT 150 - 450 x103 ARTERIAL BLOOD GAS (ABG) pH PCO2 HCO3 PO2 7.35 - 7.45 35 - 45 22 - 26 80 - 100 © 2021 NurseInTheMaking LLC Humalog Novolog Apidra Humulin R Novolin R Humulin N Novolin N Lantus Levemir ONSET 5-30 min 30-60 min 1-2 hrs 1-2 hrs PEAK 30-90 min 2-4 hrs 4-12 hrs none 1 L = 1,000 mL DURATION 3-5 hrs 5-7 hrs 18-24 hrs 24+ hrs 1 kg = 2.2 lbs AST 5 - 40 ALT 7 - 56 ALP 40 - 120 RENAL DIAGRAM Ca 9 - 11 Mg 1.5 - 2.5 Phos 2.5 - 4.5 0 1+ 2+ 3+ 4+ 1+ 2+ 1 g = 1,000 mg 1 oz = 30 mL 8 oz = 1 cup 1 tsp = 5 mL 1 dram = 5 mL 1 tbsp = 15 mL 1 tbsp = 3 tsp 1 mL = 5 gtts (drops) 1 lb = 16 oz examples Hypertonic Isotonic Decreased everything (↓BP, ↓HR, ↓RR, ↓DTR, ↓energy) Common Labs BUN 7 - 20 brand names ↑Ca+ = ↓PO4 Bone pain, kidney stones, muscle weakness Cl Na 135 - 145 95 - 105 Glargine Detemir = inverse >11 >2.5 NPH Calcium/Phosphorus Tetany, Positive Trousseau’s, Positive Chvostek’s Signs 1 mg = 1,000 mcg Regular Iv Fluids <9 CA+ Conversions Lispro Aspart Glulisine Seizures, nausea, lethargy Change of LOC, agitation, restlessness Commonly done in neonates generic names CLASSIC S&S >145 Inner forearm Insulin After you are done taking a patients HR keep your finger on their pulse while assessing their respirations. This is easier because when the patients knows you are taking their respirations, they may breathe differently. NORMAL VALUE USUAL SITES Hypotonic pulse chart Pulse is absent Diminished Normal Full Bounding, strong edema Trace Mild swelling Mild 3+ Moderate Deep indentation remains for a short time 4+ Severe Very deep indentation that lasts a long time used for 5% saline 3% saline 5% dextrose in 0.9% saline (D5NS) 5% dextrose in 0.45% saline (D5 1⁄2 NS) 5% dextrose in LR (D5LR) 10% dextrose in water (D10W) Cerebral edema Hyponatremia Metabolic alkalosis Maintenance fluid Hypovolemia 0.9% sodium chloride (NS) (normal saline) 5% dextrose in water (D5W) Lactated Ringers (LR) Blood loss Dehydration Fluids maintenance 0.45% saline (1/2 NS) 0.33% saline (1/3 NS) 0.225 saline (1/4 NS) 5% dextrose in water (D5W) Diabetic ketoacidosis (DKA) Hypernatremia NORMAL SALINE is the only solution compatible to use with blood or blood products Charting 5+ 4+ 3+ 2+ 1+ 0 0 1+ 2+ 3+ 4+ Muscle Strength Normal Strength Moves against gravity and light resistance Moves against gravity but not resistant Moves with gravity eliminated Muscle movement w/o joint motion No muscle movement Reflexes No response absent Present, but sluggish or diminished Active or expected response normal More brisk than excited; hyperactive Brisk, hyperactive, with intermittent or transient clonus Weeping edema: Areas that have pitting edema can leak fluid out directly from the skin nursing school essentials click anywhere to shop! THE COMPLETE d Badge Car PACK 21 cards + badge reel Be prepared next time you go to clinicals with all this information at your fingertips! Bestseller 200+ pages of the most common nursing school topics! A great resource for visual learners and those who love memory tricks and mnemonics (it’s full of them!) 12-month planner specifically for nursing students h the y wit Stud 500+ Flashcards power of repetition! to help you succeed in nursing school! starter kit hour Comes wi ly whit study n th eboa o rd m tepad & arke rs! 30+ templates, worksheets & quizzes take 10% off digital downloads for all study guides! the entire shop! click me! NursingEssentials10 Dear future nurse, You may be stressed, you may feel tired, and you may want to give up. Nursing school is hard, there's no doubt about it. Everyone cries, everyone has meltdowns, and there will be moments you don't feel qualified for the task at hand. But take heart, the challenge only makes you stronger. Put in the work, show up on time, and find an amazing study group. You got this! – Kristine Tuttle, BSN, RN You got this, future nurse! By purchasing this material, you agree to the following terms and conditions: you agree that this ebook and all other media produced by NurseInTheMaking LLC are simply guides and should not be used over and above your course material and teacher instruction in nursing school. When details contained within these guides and other media differ, you will defer to your nursing school’s faculty/staff instruction. Hospitals and universities may differ on lab values; you will defer to your hospital or nursing school’s faculty/staff instruction. These guides and other media created by NurseInTheMaking LLC are not intended to be used as medical advice or clinical practice; they are for educational use only. You also agree to not distribute or share these materials under any circumstances; they are for personal use only. © 2021 NurseInTheMaking LLC. All content is property of NurseInTheMaking LLC and www.anurseinthemaking.com. Replication and distribution of this material is prohibited by law. All digital products (PDF files, ebooks, resources, and all online content) are subject to copyright protection. Each product sold is licensed to an individual user and customers are not allowed to distribute, copy, share, or transfer the products to any other individual or entity, they are for personal use only. Fines of up to $10,000 may apply and individuals will be reported to the BRN and their school of nursing.