The Complete Nursing School Bundle

194 Pages·2021·22.173 MB·English

by  Kristine Tuttle

THE COMPLETE
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Nurse
BROUGHT TO YOU BY
in the making
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Nurse
in the making
WWW.ETSY.COM/SHOP/NURSEINTHEMAKING
@KRISTINE_NURSEINTHEMAKING
@NURSESINTHEMAKING
[email protected]
@NURSEINTHEMAKINGKRISTINE
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.
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TABLE OF CONTENTS
Head To Toe Assessment ..................................................................4
Dosage Calculation ........................................................................6
Lab Value Cheat Sheet...................................................................18
Lab Value Memory Tricks ...............................................................19
Blood Types ...............................................................................20
Electrolyte Imbalances ..................................................................21
Fundamentals ............................................................................ 25
Pharmacology: Suffixes, Prefixes, & Antidotes .....................................40
Mental Health Disorders ..............................................................48
Mental Health Pharmacology ......................................................... 58
Mother Baby ............................................................................. 64
Pediatric Development Milestones ....................................................81
Pediatrics ................................................................................. 86
Med-Surg
Renal / Urinary System ........................................................104
Cardiac System ...................................................................113
Endocrine System ................................................................137
Respiratory Disorders .......................................................... 147
Hematology Disorders .......................................................... 153
Gastrointestinal Disorders .................................................... 156
Neurological Disorders ......................................................... 161
Burns ..............................................................................166
ABG’s ..............................................................................170
Templates & Planners ................................................................. 174
Note from Kristine .................................................................... 193
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HEAD-TO-TOE ASSESSMENT
Introduction Orientation "Normal" Vital Signs
INSPECT •Knock • What is your name?
PULSE: 60-100 bpm
•Introduce yourself • Do you know where you are?
PALPATE
BLOOD PRESSURE:120/80 mmHg
• Wash hands • Do you know what month it is?
PERCUSS •Provide privacy • Who is the current U.S. president? O2 SATURATION: 95-100%
• Verify patient ID and DOB • What are you doing here? TEMPERATURE: 97.8-99.1° F
AUSCULTATE
•Explain what you are doing • A&O X4 = Oriented to Person, RESPIRATIONS: 12-20 breaths per min
(using non-medical language) Place, Time, and Situation
Head & Face Neck, Chest (Lungs) & Heart
HEAD NECK
•Inspect head/scalp/hair •Inspect and palpate
•Palpate head/scalp/hair •Palpate carotid pulse
•Check skin turgor (under clavicle)
FACE
POSTERIOR CHEST
•Inspect
•Check for symmetry •Inspect
• To assess Cranial Nerve 7, check the following: • Auscultate lung sounds in posterior and lateral chest
–Raise eyebrows – Note any crackles or diminished breath sounds
– Smile
ANTERIOR CHEST
– Frown
–Show teeth •Inspect:
–Puff out cheeks
– Use of accessory muscles
– Tightly close eyes
– AP to transverse diameter
EYES – (cid:54)(cid:87)(cid:72)(cid:85)(cid:81)(cid:88)(cid:80)(cid:3)(cid:70)(cid:82)(cid:81)(cid:73)(cid:76)(cid:74)(cid:88)(cid:85)(cid:68)(cid:87)(cid:76)(cid:82)(cid:81)
•Inspects external eye structures •Palpate: symmetric expansion
•Inspect color of conjunctiva and sclera • Auscultate lung sounds – anterior(cid:1)and lateral
•PERRLA – Note any crackles or diminished breath sounds
– Pupils Equal, Round, Reactive to Light,
HEART
& Accommodation
• Auscultate heart sounds (A, P, E, T, M)
with diaphragm and bell
– Note any murmurs, whooshing, bruits,
(cid:82)(cid:85)(cid:3)(cid:80)(cid:88)(cid:73)(cid:374)(cid:72)(cid:71)(cid:3)(cid:75)(cid:72)(cid:68)(cid:85)(cid:87)(cid:3)(cid:86)(cid:82)(cid:88)(cid:81)(cid:71)(cid:86)
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Peripherals Spine
PERIPHERALS ELBOWS
•Have the patient stand up (if able)
Upper extremities •Inspect, palpate, and assess •Inspect the skin on the back
•Inspect and palpate. •Inspect: spinal curvature
HANDS AND FINGERS
(cervical/thoracic/lumbar)
•Note any texture, lesions, temperature,
(cid:344)(cid:44)(cid:81)(cid:86)(cid:83)(cid:72)(cid:70)(cid:87)(cid:3)(cid:75)(cid:68)(cid:81)(cid:71)(cid:86)(cid:18)(cid:373)(cid:81)(cid:74)(cid:72)(cid:85)(cid:86)(cid:18)(cid:81)(cid:68)(cid:76)(cid:79)(cid:86)
moisture, tenderness, & swelling •Palpate spine
(cid:344)(cid:51)(cid:68)(cid:79)(cid:83)(cid:68)(cid:87)(cid:72)(cid:3)(cid:75)(cid:68)(cid:81)(cid:71)(cid:86)(cid:3)(cid:68)(cid:81)(cid:71)(cid:3)(cid:373)(cid:81)(cid:74)(cid:72)(cid:85)(cid:3)(cid:77)(cid:82)(cid:76)(cid:81)(cid:87)(cid:86)
•Palpate radial pulses bilaterally •Note any lesions, lumps,
(+1, +2, +3, +4) •Check muscle strength of hands bilaterally or abnormalities
– Does each hand grip evenly?
SHOULDER
+1 = Diminished +3 =Full
•Inspect, palpate, and assess
+2 =”Normal” +4 =Bounding, strong
Lower Extremities (hips, knees, ankles) Abdomen
LOWER EXTREMITIES •Inspect:
–Skin color
•Inspect:
–Contour
–Overall skin coloration
–Scars
– Lesions
– Aortic pulsations
–Hair distribution
– Varicosities • Auscultate bowel sounds:
– Edema all 4 quadrants (start in RLQ and go clockwise)
•Palpate: Check for edema (pitting or non-pitting) •Light palpation: all 4 quadrants
(cid:344)(cid:38)(cid:75)(cid:72)(cid:70)(cid:78)(cid:3)(cid:70)(cid:68)(cid:83)(cid:76)(cid:79)(cid:79)(cid:68)(cid:85)(cid:92)(cid:3)(cid:85)(cid:72)(cid:373)(cid:79)(cid:79)(cid:3)(cid:69)(cid:76)(cid:79)(cid:68)(cid:87)(cid:72)(cid:85)(cid:68)(cid:79)(cid:79)(cid:92)
ABSENT: Must listen for at least 5 minutes to chart
absent bowel sounds
HIPS
•Inspect and palpate HYPOACTIVE: One bowel sound every 3-5 minutes
NORMOACTIVE: Gurgles 5-30 time per minute
KNEES
HYPERACTIVE: Can sometimes be heard without a
•Inspect and palpate
stethoscope constant bow(cid:70)l sounds,
ANKLES >30 sounds per minute
•Inspect and palpate
OVERALL
•Post tibial pulse (+1, +2, +3, +4)
•Dorsal pedis pulse bilaterally (+1, +2, +3, +4) •Positions and drapes patient appropriately
during exam (gave patient privacy)
– Check strength bilaterally
•Gave patient feedback/instructions
–(cid:39)(cid:82)(cid:85)(cid:86)(cid:76)(cid:374)(cid:72)(cid:91)(cid:76)(cid:82)(cid:81)(cid:3)(cid:374)(cid:72)(cid:91)(cid:76)(cid:82)(cid:81)(cid:3)(cid:68)(cid:74)(cid:68)(cid:76)(cid:81)(cid:86)(cid:87)(cid:3)(cid:85)(cid:72)(cid:86)(cid:76)(cid:86)(cid:87)(cid:68)(cid:81)(cid:70)(cid:72)
•Exhibits professional manner during exam,
treated patient with respect and dignity
•Organized: exam followed a logical sequence
(order of exam “made sense”)
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v
DOSAGE
CALCULATION
BROUGHT TO YOU BY
Nurse
in the making
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ABBREVIATIONS
EXAMPLE
TIMES OF MEDICATIONS A patient is receiving 1 mg tid.
How many mg will they receive in one day?
Remember: tid = 3X a day
ac before meals
Answer: if they are receiving 1 mg for 3X a day,
pc after meals that’s 1 mg x 3 = 3 mg per day
daily every day
ROUTES OF ADMINISTRATION
bid two times a day
tid three times a day
PO by mouth
qid four times a day
IM intramuscularly
qh every hour
PR per rectum
ad lib as desired SubQ subcutaneously
stat immediately SL sublingual
ID intradermal
q2h every 2 hours
GT gastrostomy tube
q4h every 4 hours
IV intravenous
q6h every 6 hours
IVP intravenous push
prn as needed IVPB intravenous piggyback
hs at bedtime NG nasogastric tube
APOTHECARY
DRUG PREPARATION METRIC
AND HOUSEHOLD
tab, tabs tablet gtt drop
g (gm, Gm) gram
cap, caps capsule min, m, mx minim
mg milligram
gtt drop tsp teaspoon
mcg microgram
EC enteric coated pt pint
CR controlled release kg (Kg) kilogram gal gallon
susp suspension L liter dr dram
el, elix elixir oz ounce
mL milliliter
sup, supp suppository T, tbs, tbsp tablespoon
mEq milliequivalent
SR sustained release qt quart
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CONVERSIONS
BASED ON VOLUME
THE METRIC SYSTEM
1 mg = 1,000 mcg
1 g = 1,000 mg Large unit to small unit move decimal to the right
Small unit to large unit move decimal to the left
1 oz = 30 mL
8 oz = 1 cup
1 tsp = 5 mL Moving to a larger unit? Move the decimal place to the Left
TIP
(Ex: mcg → mg) (Larger unit think Left)
1 dram = 5 mL
EXAMPLE
1 tbsp = 15 mL
1500 mcg = mg
1 tbsp = 3 tsp
A “mg” is larger (Larger unit think Left) than a “mcg”
1 L = 1,000 mL
Therefore you move decimal 3 places to the Left
1 mL = 15 gtts (drops) 1500. mcg = 1.500 mg (1.5 mg)
BASED ON WEIGHT
1 kg = 2.2 lbs lb kg by 2.2 kg lb by 2.2
DIVIDE MULTIPLY
1 lb = 16 oz
Example: Example:
120 lbs = _____kg 45.6 kg = ______lb
120 lbs / 2.2 = 54.545 kg 45.6 kg x 2.2 = 100.32 lb
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DOSAGE CALC RULES
KEY
Medication errors kill,
PREVENTION is crucial!
1
Show ALL your work.
2
Leading zeros must be placed before any decimal point.
The decimal point may be missed without the zero
EXAMPLE
.2 mg should be 0.2 mg
.2 could appear to be 2
WHY?
(0.2 mg of morphine is VERY different than 2 mg of morphine!)
3
No trailing zeros.
0.7 mL NOT 0.70 mL
1 mg NOT 1.0 mg
1.0 could appear to be 10!
WHY?
4
DO NOT round until you have the final anwser!
HOW TO ROUND YOUR FINAL ANSWER
If the number
→
in the thousands place The # in the hundredth place is rounded up DECIMAL REFERENCE GUIDE
is 5 or greater
EXAMPLES: 1.995 mg is rounded to 2 mg
34.732
1.985 mg is rounded to 1.99 mg
tens
ones thousandths
If the number hundredths
in the thousands place → The # is dropped tenths
is 4 or less
EXAMPLE: 0.992 mg is rounded to 0.99 mg
5
Most nursing schools, if not all, do not give partial credit.
(THIS MEANS EVERY STEP MUST BE DONE CORRECTLY!)
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FORMULA METHOD
(FOR VOLUME-RELATED DOSAGE ORDERS)
D
x
V = A
H
NOTE:
D =
DESIRED Some medications

like Heparin and Insulin
Example: “The physician orders 120 mg...” are prescribed in
units/hour
H =
DOSAGE OF MEDICATION AVAILABLE

Example: “The medication is supplied as 100 mg/5 mL”
V =
VOLUME THE MEDICATION IS AVAILABLE IN
Example: “The medication is supplied as 100 mg/5 mL”
KEY
A =
AMOUNT OF MEDICATION REQUIRED FOR ADMINISTRATION
You should assume that all
questions are asked “per dose”
Your answer unless the question gives a
timeframe (example: “how
many tablets will you give in 24
hours?”)
EXAMPLE 1 EXAMPLE 2
Ordered: Drug C 150 mg
Ordered: Drug C 10,000 units SubQ
Available: Drug C 300 mg/tab
Available: Drug C 5,000 units/mL
How many tablets should be given?
How many mL should be given?
D D
x V = A x V = A
H H
What’s our desired? Drug C 150mg PO What’s our desired? Drug C 10,000 SubQ
What do we have? Drug C 300mg/tab What do we have? Drug C 5,000 units
What’s our quantity/volume? tablets What’s our quantity/volume? 1 mL
150 mg 300 mg x 1 tab = 0.5 tabs 10,000 units 5,000 units x 1 mL = 2 mL
150 300 = 0.5 x 1 = 0.5 tabs 10,000 5,000 = 2 x 1 = 2 mL
FINAL ANSWER: 0.5 tabs FINAL ANSWER: 2 mL
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