Nclex RN Cram Sheet - nursing PDF

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Key Concepts for an NCLEX-RN Cram Sheet Vital signs    

HR: 60-100 bpm BP: 90/60 to 120/80 mm Hg RR: 12 to 20 breaths per minute Temp: 36.5 to 37.2°C (97.8-99°F)

Lab values Blood Gas     

pH: 7.35-7.45 PaO2: 80-100 mm Hg PaCO2: 35-45 mm Hg HCO3: 22-26 mEq/L SaO2: > 95%

Lipoproteins & Triglycerides       

Total: < 200 mg/dL Triglycerides: < 150 mg/dL HDL: > 60 mg/dL LDL: < 70 mg/dL AST: < 40 u/L ALT: < 40 u/L ALP: 42-128 u/L

Hematology         

HCT female: 37-47% HCT male: 42-52% HGB female: 12-16 g/dL HGB male: 14-18 g/dL WBC: 5,000-10,000 /uL Platelets: 150,000-400,000 mm 3 PT: 11-12.5 seconds (1.5-2.5 times this if on Warfarin) aPTT: 30-40 seconds (1.5-2 times this if on Heparin) INR: on Warfarin 2-3, not on Warfarin 0.8-1.1

Cardiac markers    

Troponin: < 0.01 ng/mL C-reactive protein: ≤ 0.8 mg/dL CD40 ligand: 1.51-5.35 mg/L Creatinine kinase: 0-3 mcg/L

Serum electrolytes      

Sodium: 135-145 mEq/L Potassium: 3.5-5 mEq/L Chloride: 98-106 mEq/L Calcium: 9-10.5 mEq/L Magnesium: 1.3-2.1 mEq/L (therapeutic range), 4-7 mEq/L if on magnesium Phosphorus: 3.5-4.5 mEq/L

Chemistry            

Amylase: 56-90 IU/L Lipase: 0-110 units/L Total bilirubin: 0-1 mg/dL Albumin: 3.5-5 g/dL Alfa-fetoprotein: < 10 ng/mL is normal for adults > 500 could indicate liver tumors. Ammonia: 15-110 mg/dL BUN: 10-20 mg/dL Serum creatinine: 0.6-1.2 mg/dL Creatinine clearance: females 80-125 mL/min, males 90-139 mL/min GFR: 125 mL/min Fasting blood glucose: < 100 mg/dL HbA1C: < 5.7 is normal, 5.7-6.4 prediabetic, 6.5 or higher on two separate tests means diabetes.

Thyroid function   

Total T3: 70-205 ng/dL T4: 4-12 mcg/dL TSH: 0.4-0.6 microunits/mL

Urinalysis          

Urine spec grav: 1.003-1.030 Volume: 1-2 L/day pH: 4.5-8 Glucose: < 130 mg/dL RBC: ≤ 3 RBCs WBCs: ≤ 2-5 WBCs/hpf Protein: ≤ 150 mg/dL Bacteria: none Ketones: none Nitrites: neg

Conversions       

1 tsp = 5 mL 1 tbsp = 3 tsp 1 oz = 30 mL 1 cup = 8 oz 1 pint = 2 cups 1 quart = 2 pints 1 kg = 2.2 lbs

Therapeutic drug levels        

Carbamazepine: 4-12 mcg/mL Digoxin: 0.8-2 ng/mL Gentamycin: 5-10 mcg/mL Lithium: 0.8-1.5 mEq/L Phenobarbital: 10-40 mcg/mL Phenytoin: 10-20 mcg/mL Theophylline: 10-20 mcg/dL Valproic acid: 50-125 mcg/mL, toxic if greater than 150 mcg/mL

Pharmacology

Maternity concepts

Knowing every single drug may seem like an impossible feat. But by adding drug categories and their corresponding name endings to your NCLEX-RN cram sheet, memorization will become easier, and you’ll be able to eliminate many answer choices on your pharm questions!

FHR: 120-160 BPM

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ACE inhibitors end in: -pril (lisinopril) Beta-blockers end in: -olol (propranolol) Abx end in: -ycin or -cillin (erythromycin, penicillin) Benzodiazepines end in: -pam (diazepam) Phenothiazines end in: -zine (promethazine) Glucocorticoids end in: -one (prednisone) Antivirals end in: -vir (acyclovir) Cholesterol lowering drugs end in: -statin (atorvastatin) ARBs end in: -artan (valsartan) H2 receptor blockers end in: -tidine (cimetidine) PPIs end in: -azole (pantoprazole) Anticoagulants end in: -arin (heparin)

Acid-base balance Most nursing students agree that acid-base balance questions are among the most challenging. Luckily, this tip will help you work your way through these difficult questions: Simply remember ROME (respiratory opposite/metabolic equal). If the imbalance is respiratory, the pH and PaCO2 will move in opposite directions to correct. If the imbalance is metabolic, the pH and HCO3 will move in the same direction to correct. Here’s a breakdown of how to figure out what type of alkalosis or acidosis someone is experiencing:

Decelerations: The trick here is to remember VEAL CHOP. Yes, VEAL CHOP. Then you need to do some practice questions that involve interpreting strips.    

Variable – Cord Early – Head Accelerations – Ok Late – Placental insufficiency

Pregnancy drug categories     

A: No risk, human studies have been done. B: No risk in non-human studies. C: Not enough research to determine risk. D: Evidence of risk in humans. Avoid in pregnancy if at all possible. X: Contraindicated in pregnancy.

APGAR scores Done at 1 and 5 minutes after birth. 0 points for absent, 1 for decreased, 2 for present. Total score from 0-3 is low, 4-6 is moderately abnormal, 7-10 is reassuring     

Appearance (color: blue or pale, acrocyanotic, completely pink) Pulses (heart rate: absent, 100 bmp) Grimace (reflex irritability: no response, grimace, cry or active withdrawal) Activity (muscle tone: limp, some flexion, active motion) Respiration (absent, weak cry, good cry)

Glucose testing for gestational diabetes    

Respiratory acidosis: pH low, PaCO2 high, HCO3 normal Respiratory alkalosis: pH high, PaCO2 low, HCO3 normal Metabolic acidosis: pH low, PaCO2 normal, HCO3 low Metabolic alkalosis: pH high, PaCO2 normal, HCO3 high

If the body has started to compensate for any of these situations, it will show in the opposite system. For example, partially compensated respiratory acidosis will still have a low pH, but the HCO3 will increase to correct the acidosis. If fully compensated, the pH will be normal again. For partially compensated metabolic acidosis, the pH will be low, and the PaCO2 will lower to correct the acidosis.

GCT: Glucose challenge test (remember, everyone gets CHALLENGED at 24-28 weeks gestation). Patient drinks glucola and 1 hour later has blood drawn. If < 140 mg/dL, it’s considered normal and no GTT is necessary. If ≥ 140 mg/dL, patient has to move on to a GTT. The patient can eat and drink normally before the GCT. GTT: Glucose tolerance test. The patient should eat and drink normally in days leading up to test but should fast for the 8 hours before the test. They will have a blood draw for a fasting glucose level. Then, the patient will drink glucola and have blood drawn at 1 and 2 hours after finishing the drink. Two or more of the following abnormal results indicates gestational diabetes:    

Fasting: > 95 mg/dL 1 hr: > 180 mg/dL 2 hr: > 155 mg/dL 3 hr: > 140 mg/dL

NST: FHR accelerates at least 15 beats above baseline for 15 seconds 2 times in 20 minutes = reactive which is normal. Otherwise non-reactive. AVA: The umbilical cord has 2 arteries and 1 vein. STOP: This is the procedure for maternal hypotension after anesthesia.    

Stop Pitocin Turn on left side Oxygen Push IV fluids if hypovolemic

Tricks of the trade The following tricks will help you memorize concepts that are guaranteed to appear on your NCLEX-RN exam. ABCs for prioritizing care:   

Airway: Is it clear? Breathing: Is the patient breathing? Circulation: What is the HR?

Rule of nines for total body surface area for burns:      

Head: 9% Arms: 9% each (18% total) Back: 18% total Chest & abdomen: 18% total Legs: 18% each (36% total) Genitalia: 1%

TORCH: This is for remembering some of the most common infections that cause congenital anomalies in the newborn.     

T: Toxoplasmosis O: Other (syphilis, varicella-zoster, parovirus B19) R: Rubella C: Cytomegalovirus H: Herpes

Use the ideas and guidelines provided here as you create your own NCLEX-RN cram sheet, but be sure to personalize it too! Focus on the areas that give you the most difficulty. As you review your cram sheet, you’ll build confidence, sleep peacefully, and head into your NCLEX-RN exam rested and prepared!...