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Updated October 13, 2026 CinnaRN Clinical Content Team Free to read, print and share

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Management of Care24 cheat sheets Safety & Infection Control44 cheat sheets Health Promotion & Maintenance21 cheat sheets Psychosocial Integrity18 cheat sheets Basic Care & Comfort14 cheat sheets Pharmacological Therapies112 cheat sheets Reduction of Risk Potential12 cheat sheets Physiological Adaptation243 cheat sheets

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HypokalemiaK+ < 3.5 mEq/L Popular HyperkalemiaK+ > 5.0 mEq/L Popular HyponatremiaNa+ < 135 mEq/L Digoxin ToxicityDig level > 2.0 ng/mL Popular Heart FailurePump fails → congestion Popular Diabetic Ketoacidosis (DKA)Glucose > 250, pH < 7.35 Popular HypoglycemiaGlucose < 70 mg/dL Increased Intracranial PressureICP > 20 mmHg Heparin TherapyMonitor aPTT, antidote protamine Warfarin TherapyMonitor INR, antidote vit K COPDChronic airflow obstruction Sepsis and Septic ShockInfection → organ failure Pregnancy-Induced HypertensionBP ≥ 140/90 after 20 wks Group B StreptococcusScreen 36-37 wks gestation Umbilical Cord ProlapseCord before fetus = emergency Cesarean CareSurgical birth, abdominal Immunization ScheduleLive vaccines = ≥ 12 mo Pediatric Pain AssessmentMatch scale to age/development Lead PoisoningBlood lead ≥ 5 mcg/dL Acetaminophen Poisoning in ChildrenAntidote = N-acetylcysteine Child Abuse RecognitionInjury inconsistent with story Failure to ThriveWeight < 5th percentile Pediatric Fluid Maintenance4-2-1 mL/kg/hr rule Car Seat SafetyRear-facing until 2 yr min Poison ControlCall 1-800-222-1222 Otitis MediaMiddle ear infection Pediatric Fever ManagementTemp ≥ 100.4°F (38°C)Therapeutic Communication TechniquesOpen-ended, patient-centered Defense MechanismsUnconscious anxiety protection Restraint and Seclusion SafetyLeast restrictive, last resort Electroconvulsive TherapyInduced seizure for severe depression Serotonin SyndromeToo much serotonin = hyperthermia Neuroleptic Malignant SyndromeAntipsychotic emergency: lead-pipe rigidity Tardive DyskinesiaLate involuntary movements, often irreversible Lithium ToxicityToxic > 1.5 mEq/L Crisis InterventionShort-term, here-and-now focus De-escalationCalm the agitated patient first Grief and LossNormal vs complicated grieving Arterial Blood Gas InterpretationpH 7.35-7.45 normal Complete Blood CountWBC, Hgb, Hct, platelets Basic Metabolic PanelNa K Cl CO2 BUN Cr Glu Ca Coagulation Studies (PT/INR/aPTT)Warfarin → INR; Heparin → aPTT Cardiac Biomarkers (troponin/BNP)Troponin = MI; BNP = HF Liver Function TestsALT/AST = hepatocyte damage Therapeutic Drug LevelsMemorize narrow-window values ABO Blood CompatibilityO- universal donor Creatinine and BUNKidney function markers Hemoglobin A1C3-month avg glucose Ammonia Level↑ = hepatic encephalopathy Low-Sodium DietNa < 2,000-2,300 mg/day Renal DietLow Na, K, phos, protein Diabetic DietConsistent carb counting Low-Protein DietFor liver/kidney failure High-Fiber Diet25-38 g fiber/day Clear Liquid DietSee-through liquids only Full Liquid DietLiquids + smooth dairy Cardiac DietLow salt, fat, cholesterol Low-Residue DietLow fiber, ↓bowel bulk Dysphagia DietThickened liquids, aspiration risk Gluten-Free DietNo wheat, barley, rye Potassium-Modified DietK+ normal 3.5-5.0 mEq/L Total Parenteral NutritionIV nutrition via central line Informed ConsentMD explains, nurse witnesses Advance DirectivesClient's future-care wishes HIPAA and ConfidentialityProtect health info → need-to-know Mandatory ReportingSuspected abuse → must report Patient Bill of RightsRespect, info, refuse, privacy Negligence and MalpracticeDuty-Breach-Harm-Causation Scope of PracticeDefined by state Nurse Practice Act Living Will and Power of AttorneyWill = wishes, POA = decider Do Not Resuscitate OrdersNo CPR/intubation if arrest Ethical Principles (autonomy/beneficence)Autonomy = pt's right to choose Delegation to UAPStable, predictable, routine tasks Delegation to LPN/LVNStable pts, reinforce teaching Prioritization (ABCs)Airway → Breathing → Circulation Maslow Hierarchy in NursingPhysiologic needs first Triage PrinciplesSickest survivable treated first Five Rights of DelegationTask, Circumstance, Person, Direction, Supervision Time ManagementPrioritize, cluster, delegate Acuity-Based AssignmentMatch pt complexity to skill Care of Multiple ClientsSee most unstable first Piaget Cognitive Development4 stages of thinking Adolescent Health ScreeningHEEADSSS + risk behaviors Adult Preventive ScreeningAge-based cancer + risk screens Older Adult SafetyFalls = #1 injury risk Developmental Milestones by AgeRed flags = no milestone by age Health Promotion Across LifespanPrevention: primary/secondary/tertiary Vaccination for AdultsFlu yearly, Td/Tdap q10y Cancer Screening GuidelinesColonoscopy q10yr start age 45 MenopauseNo menses ×12 months Pain Assessment ScalesPain = 5th vital sign Patient-Controlled AnalgesiaONLY patient pushes button Opioid-Induced Respiratory DepressionRR < 8-10 = give naloxone Postoperative Atelectasis PreventionIS 10× per waking hour Postoperative IleusNo bowel sounds/flatus = ileus Wound Dehiscence and EviscerationOrgans out = cover sterile saline Anesthesia RecoveryAirway first in PACU Conscious Sedation MonitoringPt responds to verbal commands Cardiac Arrest and CPR BasicsPush hard 100-120/min Choking and Airway ObstructionCan't cough/speak = abdominal thrusts Hemorrhage ControlDirect pressure first Burns Emergency CareAirway first, then fluids HypothermiaCore temp < 95°F (35°C)Heat StrokeTemp > 104°F + no sweat Poisoning General ManagementCall Poison Control 1-800-222-1222 DrowningRescue breaths first priority Acute Stroke Recognition (FAST)Time is brain — note onset Shock Recognition↓BP, ↑HR, ↓UO = shock NitroglycerinHold if SBP < 90 DopamineDose-dependent effects; central line DobutamineBeta-1 inotrope for HF NitroprussideWatch cyanide toxicity ClopidogrelAntiplatelet — bleeding risk Statins (atorvastatin)Take at night; check liver/muscle AdenosineRapid IV push for SVT DiltiazemNon-DHP CCB → slows AV node HydralazineDirect arteriolar vasodilator SpironolactoneK+-sparing diuretic → watch hyperK+Alteplase (tPA)Clot-buster → bleeding is #1 risk Aspirin (antiplatelet)Irreversible COX → ↓ platelet aggreg.MontelukastLeukotriene blocker → PREVENTION only IpratropiumAnticholinergic bronchodilator (SAMA)TheophyllineNarrow range: 10-20 mcg/mL Diphenhydramine1st-gen antihistamine → sedating PseudoephedrineSympathomimetic → ↑ BP & HR Inhaled CorticosteroidsAsthma controller → not rescue GuaifenesinExpectorant → thins secretions CromolynMast cell stabilizer → PREVENTION Oxygen Therapy SafetyO2 = drug → fire hazard, COPD watch Proton Pump Inhibitors-prazole → ↓ gastric acid strongly H2 Receptor Blockers-tidine → ↓ acid, weaker than PPI Ondansetron5-HT3 blocker → watch QT prolong MetoclopramideProkinetic → tardive dyskinesia risk BisacodylStimulant laxative → fast acting LoperamideAntidiarrheal → opioid, no CNS SucralfateForms protective ulcer barrier DocusateStool softener → prevents straining Lactulose↓ ammonia → treats hepatic enceph.AntacidsNeutralize acid → fast, short relief SertralineSSRI → full effect 4-6 weeks VenlafaxineSNRI → may ↑ BP, watch DBP PhenelzineMAOI → tyramine = HTN crisis AmitriptylineTCA → lethal in overdose (cardiac)BupropionAtypical → lowers seizure threshold BuspironeNon-sedating anxiolytic, slow onset Valproic AcidHepatotoxic + teratogen HaloperidolTypical antipsychotic → EPS risk ClozapineAgranulocytosis → monitor ANC RisperidoneAtypical → ↑prolactin MethylphenidateCNS stimulant for ADHD Glipizide (Sulfonylurea)Stimulates insulin → hypoglycemia GlucagonRescue for severe hypoglycemia GLP-1 AgonistsWeight loss + pancreatitis risk SGLT2 InhibitorsGlucose in urine → UTI risk Propylthiouracil (PTU)Hyperthyroid; safer 1st trimester MethimazoleHyperthyroid; NOT 1st trimester Desmopressin (DDAVP)Synthetic ADH → water retention Hydrocortisone ReplacementAdrenal insufficiency → never stop FludrocortisoneMineralocorticoid → retains Na+/water OctreotideSomatostatin analog → ↓ secretions Abdominal Aortic Aneurysm (AAA)Pulsatile mass → rupture = fatal Raynaud PhenomenonVasospasm → white-blue-red fingers Thromboangiitis Obliterans (Buerger Disease)Smoking → small-vessel occlusion Mitral Valve StenosisLA → LV obstruction → pulm congestion Aortic StenosisTriad: angina, syncope, dyspnea Rheumatic FeverPost-strep → damages heart valves Varicose VeinsIncompetent valves → venous pooling Chronic Venous InsufficiencyStasis ulcers + brown skin Hypertensive CrisisBP > 180/120 → organ damage Orthostatic Hypotension↓20 SBP standing → dizzy/fall Bell PalsyCN VII → one-sided facial droop Trigeminal NeuralgiaCN V → stabbing facial pain Huntington DiseaseAutosomal dominant → chorea + dementia EncephalitisBrain inflammation → altered LOC Migraine HeadacheUnilateral throbbing + photophobia Cluster HeadacheSevere unilateral periorbital pain Cerebral Aneurysm"Worst headache of life"ConcussionMild TBI, transient dysfunction Brain Tumor↑ICP from mass effect Cauda Equina SyndromeSurgical emergency <48h DiverticulitisLLQ pain + fever HemorrhoidsBright red rectal bleeding Inguinal HerniaGroin bulge w/ straining Irritable Bowel SyndromeFunctional, no structural damage Celiac DiseaseGluten → villi destruction Polycystic Kidney DiseaseGenetic cysts → renal failure Testicular TorsionSurgery <6h or lose testis EpididymitisGradual scrotal pain + fever Diabetic NephropathyAlbuminuria = earliest sign HydronephrosisUrine backup → kidney swelling AcromegalyExcess GH in adults Metabolic Syndrome3+ of 5 risk factors Polycystic Ovary SyndromeAnovulation + hyperandrogenism Diabetes Insipidus vs SIADHDI = dry, SIADH = soaked Hashimoto ThyroiditisAutoimmune hypothyroidism GoiterEnlarged thyroid gland Adrenal CrisisAcute cortisol deficiency = shock Hypopituitarism↓ anterior pituitary hormones Gestational Diabetes Screening24-28 wks: 1-hr 50g OGTT Obesity ManagementBMI ≥30 kg/m² HemophiliaX-linked, ↓ clotting factor Von Willebrand DiseaseMost common inherited bleed Polycythemia Vera↑↑ RBCs → thick blood Immune Thrombocytopenic PurpuraPlatelets <100k, autoimmune Breast CancerNew painless breast lump Lung CancerSmoking = #1 cause Colorectal CancerColonoscopy at age 45 Prostate CancerMost common male cancer Tumor Lysis Syndrome↑K ↑PO4 ↑uric acid, ↓Ca Superior Vena Cava SyndromeOncologic emergency, face swelling Graft-versus-Host DiseaseDonor cells attack host Hydatidiform MoleGrape-like cluster, huge hCG TORCH InfectionsCross placenta → fetal harm Neonatal JaundiceBili before 24h = pathologic Respiratory Distress Syndrome (newborn)Surfactant deficiency in preterm Necrotizing EnterocolitisPreterm gut emergency Neonatal Abstinence SyndromeWithdrawal from maternal opioids Shoulder DystociaTurtle sign, OB emergency Amniotic Fluid EmbolismSudden collapse during labor MastitisUnilateral red, warm wedge Gestational Age AssessmentBallard score after birth ParacentesisDrain ascites from abdomen ThoracentesisDrain pleural fluid, sit up Lumbar PunctureFetal position, lie flat after Bone Marrow BiopsyIliac crest, pressure after Colonoscopy PrepClear liquids + bowel cleanse Cardiac CatheterizationCheck pulses, lie flat after MRI SafetyNo metal in the magnet CT with ContrastCheck renal + iodine allergy Blood Culture CollectionBefore antibiotics, 2 sites Arterial Blood Gas SamplingAllen test, ice, pressure 5min Lumbar Drain CareDrains CSF, level at tragus HypernatremiaNa+ > 145 mEq/L HypercalcemiaCa+ > 10.5 mg/dL HypocalcemiaCa²⁺ < 9.0 mg/dL HypomagnesemiaMg²⁺ < 1.5 mEq/L HypermagnesemiaMg²⁺ > 2.5 mEq/L HypophosphatemiaPhos < 3.0 mg/dL Metabolic Acidosis↓ pH, ↓ HCO₃⁻Metabolic Alkalosis↑ pH, ↑ HCO₃⁻Respiratory Acidosis↓ pH, ↑ CO₂ (hypoventilation)Respiratory Alkalosis↑ pH, ↓ CO₂ (hyperventilation)Fluid Volume Deficit (dehydration)Fluid loss > intake Fluid Volume ExcessFluid intake > output Myocardial InfarctionIschemic heart muscle death Angina PectorisChest pain, no muscle death HypertensionBP ≥ 130/80 mmHg Atrial FibrillationIrregular, no P waves Heart Blocks (AV block)Impaired AV conduction Infective EndocarditisInfected heart valves/lining PericarditisInflamed pericardial sac Cardiac TamponadeFluid compresses heart Peripheral Arterial Disease↓ arterial flow to limbs Deep Vein ThrombosisClot in deep vein Cardiogenic ShockPump failure → ↓ CO Hypovolemic Shock↓ blood/fluid volume AsthmaReversible airway narrowing PneumoniaLung infection, alveoli fill TuberculosisAirborne, acid-fast bacilli Pulmonary EmbolismClot blocks lung artery ARDSRefractory hypoxemia PneumothoraxAir in pleural space Chest Tube ManagementDrains air/fluid, re-expands lung Pleural EffusionFluid in pleural space AtelectasisCollapsed alveoli → ↓ gas exchange Acute Respiratory FailurePaO2 <60 or PaCO2 >50 Pulmonary EdemaPink frothy sputum = hallmark Hyperthyroidism (Graves Disease)↓ TSH, ↑ T3/T4 → hypermetabolic Hypothyroidism (Myxedema)↑ TSH, ↓ T3/T4 → hypometabolic Thyroid Storm (Thyrotoxic Crisis)Temp >104°F + tachycardia = emergency Cushing Syndrome↑ cortisol → ↑ Na, ↓ K, ↑ glucose Addison Disease (Adrenal Insufficiency)↓ cortisol → ↓ Na, ↑ K, hypotension SIADH (Syndrome of Inappropriate Antidiuretic Hormone)Too much ADH → dilutional ↓ Na Diabetes InsipidusToo little ADH → massive dilute urine Hyperosmolar Hyperglycemic State (HHS)Glucose >600, NO ketosis Hyperparathyroidism↑ PTH → ↑ Ca, ↓ phosphate Hypoparathyroidism↓ PTH → ↓ Ca, ↑ phosphate PheochromocytomaAdrenal tumor → catecholamine surge Stroke (CVA)FAST → time = brain Transient Ischemic AttackStroke signs <24h, NO infarct Seizure DisorderSafety first → never restrain Parkinson Disease↓ dopamine → TRAP Multiple SclerosisDemyelination → relapse/remit Myasthenia Gravis↓ ACh receptors → weakness worse w/ use Guillain-Barre SyndromeAscending paralysis, watch breathing Bacterial MeningitisNuchal rigidity + fever = droplet Spinal Cord InjuryC3-C5 keeps diaphragm alive Autonomic DysreflexiaInjury ≥T6: severe HTN + headache Amyotrophic Lateral SclerosisMotor neuron death, mind intact Upper GI BleedHematemesis + melena = bleed CirrhosisScarred liver → portal HTN Hepatic Encephalopathy↑ ammonia → confusion, asterixis Acute Pancreatitis↑ lipase/amylase + epigastric pain CholecystitisRUQ pain + Murphy's sign Peptic Ulcer DiseaseH. pylori + NSAIDs = ulcer Crohn DiseaseMouth→anus, skip lesions, transmural Ulcerative ColitisColon only, bloody diarrhea Bowel ObstructionNo stool/flatus, distension AppendicitisRLQ McBurney's point pain GERDWeak LES → acid reflux HepatitisA/E fecal-oral, B/C/D blood Acute Kidney InjurySudden ↓GFR, often reversible Chronic Kidney DiseaseGFR <60 for >3 months HemodialysisAV fistula = lifeline, protect it Peritoneal DialysisCloudy effluent = peritonitis Nephrotic SyndromeMassive proteinuria >3.5 g/day Acute GlomerulonephritisPost-strep, tea-colored urine Urinary Tract InfectionDysuria, frequency, urgency PyelonephritisKidney infection + flank pain Nephrolithiasis (kidney stones)Severe colicky flank pain Benign Prostatic HyperplasiaEnlarged prostate, weak stream Iron-Deficiency AnemiaMicrocytic, ↓ferritin Pernicious AnemiaB12 def → neuro damage Sickle Cell CrisisSickled RBCs → vaso-occlusion Leukemia↑↑ immature WBCs, ↓ everything else LymphomaPainless lymph node + B symptoms ThrombocytopeniaPlatelets < 150,000 Disseminated Intravascular Coagulation (DIC)Clotting THEN bleeding everywhere NeutropeniaANC < 1,000 = infection risk Chemotherapy PrecautionsBone marrow suppression = main risk Blood Transfusion ReactionSTOP transfusion → saline first Multiple MyelomaPlasma cell cancer → bone + Ca↑Fracture5 P's = neurovascular check Compartment SyndromePain out of proportion = emergency Fat Embolism SyndromeLong-bone fx → petechiae + dyspnea Osteoporosis↓ bone density → fragility fx OsteomyelitisBone infection → fever + bone pain Total Hip ReplacementNo flexion > 90° hip Skeletal TractionWeights hang free, never lift Rheumatoid ArthritisSymmetric joints + morning stiffness OsteoarthritisAsymmetric, worse with use GoutUric acid → big toe pain Amputation CareHemorrhage = #1 early risk HIV/AIDSAIDS = CD4 < 200 cells Standard and Transmission-Based PrecautionsStandard = ALL patients, always Clostridioides difficileSoap + water, NOT sanitizer MRSAContact precautions, gown + gloves AnaphylaxisEpinephrine IM = first drug Systemic Lupus ErythematosusButterfly rash + multi-organ Tuberculosis PrecautionsAirborne: N95 + negative pressure InfluenzaDroplet precautions, sudden onset Herpes Zoster (shingles)Unilateral dermatomal painful rash PreeclampsiaBP ≥ 140/90 + proteinuria > 20 wk EclampsiaPreeclampsia + seizures Gestational DiabetesScreen 24-28 wks OGTT Placenta PreviaPainless bright red bleeding Abruptio PlacentaePAINFUL dark bleeding + rigid uterus Postpartum HemorrhageAtony = #1 cause; firm fundus Magnesium Sulfate TherapyTherapeutic 4-7 mEq/L Preterm LaborContractions 20-37 wks Fetal Heart Rate DecelerationsLate = bad; VEAL CHOP Ectopic PregnancyTubal → unilateral pain + shock Hyperemesis GravidarumSevere vomiting → wt loss + ketones CroupBarky cough + inspiratory stridor Epiglottitis4 D's — airway EMERGENCY Bronchiolitis (RSV)Wheezing infant < 2 yrs Febrile SeizuresRapid temp rise, 6mo–5yr Pediatric DehydrationSunken fontanel = severe sign Tetralogy of Fallot4 defects → TET spells Cystic FibrosisSweat chloride > 60 mEq/L Kawasaki DiseaseCoronary aneurysm = top risk IntussusceptionCurrant-jelly stool = classic Pyloric StenosisProjectile vomit, olive mass Major Depressive Disorder≥ 5 sx, 2+ weeks Bipolar DisorderMania ≥ 1 wk = priority SchizophreniaPositive + negative symptoms Generalized Anxiety DisorderExcess worry ≥ 6 months Suicide RiskPlan + means = high risk Anorexia NervosaBMI < 18.5, restricts intake Bulimia NervosaBinge + purge, normal weight Alcohol Withdrawal (DTs)DTs peak 48–72 hrs, fatal Opioid WithdrawalUncomfortable, NOT life-threatening Post-Traumatic Stress DisorderSx > 1 month post-trauma Beta Blockers-olol → hold if HR < 60 ACE Inhibitors-pril → watch dry cough + K+Calcium Channel Blockers-dipine → ↓ BP, watch edema Loop DiureticsFurosemide → watch K+ < 3.5 Opioid Analgesics and NaloxoneRR < 12 → hold opioid Insulin Types and TimingRegular = only IV insulin Corticosteroids-sone → never stop abruptly Aminoglycosides-mycin → oto + nephrotoxic AntipsychoticsWatch EPS & metabolic effects LithiumTherapeutic 0.6–1.2 mEq/L BenzodiazepinesReversal = flumazenil SSRIs and Serotonin SyndromeOnset takes 4–6 weeks Preoperative CareConsent + NPO before OR Postoperative CareAirway → breathing → circulation Malignant HyperthermiaAntidote = dantrolene STAT Moderate (Conscious) SedationKeeps protective airway reflexes Fall PrecautionsBed low, locked, call light Use of RestraintsLast resort, MD order needed Delegation PrinciplesRN keeps assessment & teaching Triage and PrioritizationABCs + Maslow first Surgical Site InfectionRedness, drainage, fever > 38°C Deep Vein Thrombosis ProphylaxisMove, hydrate, anticoagulate Burns and Rule of NinesAirway first, then fluids Pressure Injury (staging)Stage by tissue depth Wound CareMoist wound bed heals best CellulitisSpreading skin infection Stevens-Johnson SyndromeStop drug — skin emergency Glaucoma↑IOP → optic nerve damage CataractsCloudy lens, blurred vision Macular DegenerationLoss of CENTRAL vision Meniere DiseaseVertigo + tinnitus + hearing loss Detached RetinaCurtain over vision — emergency FurosemideLoop diuretic → watch K+MetforminHold before contrast dye PhenytoinTherapeutic 10–20 mcg/mL LevothyroxineReplaces thyroid hormone (T4)Prednisone (corticosteroid)Never stop abruptly MorphineHold if RR < 12 AlbuterolSABA bronchodilator → relax airways NaloxoneOpioid OD antidote (Narcan)EpinephrineAnaphylaxis + cardiac arrest 1st-line AtropineSymptomatic bradycardia → 0.5mg IV AmiodaroneAntidysrhythmic → V-tach/V-fib/AFib VancomycinMRSA → trough 10-20 mcg/mL Potassium ChlorideNEVER IV push → fatal Calcium GluconateAntidote for Mg toxicity + ↑K+Acetaminophen and N-acetylcysteineNAC = Tylenol OD antidote Sodium Polystyrene SulfonateKayexalate → lowers K+ via gut PenicillinsWatch anaphylaxis + cross-allergy CephalosporinsPCN cross-allergy + disulfiram rxn TetracyclinesNO dairy, NO kids <8, NO pregnancy FluoroquinolonesTendon rupture + QT prolong risk SulfonamidesStevens-Johnson + push fluids MacrolidesGI upset + QT prolongation IsoniazidTB drug → give B6, watch liver RifampinRed-orange body fluids (harmless)AcyclovirAntiviral → push fluids, nephro Antiretroviral TherapyART → adherence is everything Gentamicin (peak and trough)Trough <2, peak 5-10 mcg/mL MetronidazoleNO alcohol → disulfiram reaction Nasogastric Tube Insertion and CareVerify placement → X-ray gold standard Indwelling Urinary Catheter CareSterile insert · bag below bladder Central Venous Catheter CareAir embolism → clamp + left side Tracheostomy CareKeep obturator + spare tube bedside SuctioningSuction OUT only · ≤10-15 sec Wound IrrigationSterile · clean→dirty · 4-6 in Ostomy CareStoma = pink/red, moist, shiny IV Therapy and Site CareAssess site q1-2h; change q72-96h Enteral Tube FeedingVerify placement before each feed Oxygen Delivery DevicesNasal cannula 1-6 L = 24-44% O2 Incentive SpirometryPrevents atelectasis post-op Standard PrecautionsUse on ALL patients, all body fluids Contact PrecautionsGown + gloves; MRSA, VRE, C. diff Droplet PrecautionsSurgical mask within 3-6 ft Airborne PrecautionsN95 + negative-pressure room Protective (Neutropenic) IsolationProtect patient; ANC < 500 Personal Protective Equipment SequenceDon: gown→mask→goggles→gloves Sterile Technique1-inch border = unsterile Hand HygieneThe most effective way to prevent infection Needlestick ExposureWash → report → source labs STAT Catheter-Associated UTI PreventionBest prevention = early removal Central Line BundleMax barrier + chlorhexidine prep Surgical AsepsisSterile field = absolutely no microbes Stages of Labor4 stages; full dilation = 10 cm Fetal Heart Rate Monitoring BasicsBaseline 110-160 bpm APGAR ScoringScore at 1 and 5 min; max 10 Newborn AssessmentNormal HR 110-160, RR 30-60 Postpartum Assessment (BUBBLE-HE)Fundus firm, midline, at umbilicus Breastfeeding Support8-12 feeds/24h on demand Rh Incompatibility and RhoGAMRh- mom + Rh+ baby = risk SBAR Handoff CommunicationStructured nurse-to-provider report RN vs LPN vs UAP ScopeWho can do what — delegation scope Incident / Occurrence ReportQuality tool, not punishment Pain Assessment (PQRST)Pain is what the patient says it is Canes, Walkers & CrutchesCOAL · up-with-good, down-with-bad Levels of AnxietyMild → moderate → severe → panic Erikson's Psychosocial StagesTrust → Integrity across the lifespan Prenatal — GTPALObstetric history at a glance Blood Transfusion Safety2 RNs verify · stay 15 min · NS only IV Therapy ComplicationsInfiltration vs phlebitis vs infection Diagnostic Test PrepContrast, NPO & post-procedure checks Ventilator AlarmsHigh = obstruction · Low = disconnection Wernicke-Korsakoff SyndromeThiamine deficiency · confabulation · irreversible Disulfiram and Aversion TherapyAlcohol becomes a violent illness SVT and PVCsWhen a fast rhythm needs treating Dementia vs DeliriumOne is permanent, one is reversible Delusion, Hallucination, IllusionIs anything actually there?Hiatal Hernia vs Dumping SyndromeHigh everything vs low everything LaminectomyLog roll · location drives everything Lab Values by UrgencyGrade it A, B, C or D before you act Tricyclic Antidepressants2-4 weeks to work · lethal in overdose MAOIs and TyramineThe diet is the whole drug Signs of PregnancyPositive, probable, presumptive Station, Lie and PresentationThree different relationships Uterine Tetany and OxytocinStop the Pitocin first

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