Medsurg clinicals cheat sheet

normal vital signs Parenteral Administration

Blood Pressure (bp) Systolic 120 mmHg angle USUAL SITES
Diastolic 80 mmHg Intradermal (ID) 10 - 15° Inner forearm
Heart Rate (hr) 60 – 100 bpm
Subcutaneous (SUBQ) Normal/overweight: 90°
Abdomen • Posterior upper arm • Thigh
*
Respiratory rate (rr) 12 – 20 breaths/min Thin: 45°

temperature (t) 97.8 – 99°F (36.5 - 37.2°C) Intramuscular (IM) 90° Deltoid • Vastus lateralis • Ventrogluteal

oxygen (o2) 95 – 100% COPD pts are expected

Hand • Wrist
Intravenous (IV)
Commonly
* to have lower O2 levels 25°
PRO TIP:
done in
Cubital fossa • Foot • Scalp neonates

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.
Conversions
Electrolytes
1 mg = 1,000 mcg
generic Lispro
Glargine 1 g = 1,000 mg
names Aspart Regular NPH
Detemir
Glulisine 1 oz = 30 mL
NORMAL
VALUE CLASSIC S&S 8 oz = 1 cup
Humalog
brand Humulin R Humulin N Lantus 1 tsp = 5 mL
Novolog
names Novolin R Novolin N Levemir
NA+ <135 Seizures, nausea, lethargy Apidra 1 dram = 5 mL
1 tbsp = 15 mL
135 – 145 ONSET 5-30 min 30-60 min 1-2 hrs 1-2 hrs 1 tbsp = 3 tsp
mEq/L >145 Change of LOC, agitation, restlessness
1 L = 1,000 mL
PEAK 30-90 min 2-4 hrs 4-12 hrs none
1 mL = 5 gtts (drops)

K+ <3.5 Thready, weak, irregular pulse, anxiety DURATION 3-5 hrs 5-7 hrs 18-24 hrs 24+ hrs
3.5 – 5.0 1 lb = 16 oz

Iv Fluids
mEq/L
>5.0 Muscle weakness and cramps

Change of LOC, numbness,

PHOS <2.5 weakening of the bones examples used for
2.5 – 4.5 Calcium/Phosphorus
= 5% saline
mg/dL >4.5 Diarrhea, Muscle weakness, ↓DTR inverse 3% saline
Cerebral edema
Hyponatremia
↑Ca+ = ↓PO4 5% dextrose in 0.9% saline (D5NS)
Hypertonic Metabolic alkalosis
Tetany, Positive Trousseau’s, NORMAL
<9 Maintenance fluid
CA+ Positive Chvostek’s Signs 5% dextrose in LR (D5LR)
Hypovolemia SALINE
9 – 11 10% dextrose in water (D10W) is the only solution
compatible to
mg/dL
>11 Bone pain, kidney stones, muscle weakness 0.9% sodium chloride (NS) (normal saline) Blood loss use with blood
Isotonic 5% dextrose in water (D5W) Dehydration or blood
products
Lactated Ringers (LR) Fluids maintenance
<1.5 Increased everything (↑BP, ↑HR, ↑RR, ↑DTR)
MG+
1.5 – 2.5
0.33% saline (1/3 NS) Diabetic ketoacidosis (DKA)
mg/dL
>2.5 Decreased everything (↓BP, ↓HR, ↓RR, ↓DTR, ↓energy)
Hypotonic Hypernatremia
5% dextrose in water (D5W)

Common Labs Charting

BASIC METABOLIC PANEL COAGULATION
pulse chart Muscle Strength
(BMP)
PT 0 Pulse is absent 5+ Normal Strength

1+ 4+
Na Cl BUN 10 - 13 sec PTT
135 - 145 95 - 105 7 - 20 Glucose 25 - 35 sec Diminished Moves against gravity and light resistance
INR
K
3.5 - 5
HCO3 Cr
22 - 26 0.6 - 1.2
70 - 100 1-2
2+ Normal 3+ Moves against gravity but not resistant

3+ Full 2+ Moves with gravity eliminated

CBC LIVER PANEL
Hgb Total
4+ Bounding, strong 1+ Muscle movement w/o joint motion

WBC
F: 12 - 16
PLT
Bilirubin
0.1 - 1.2
edema 0 No muscle movement
M: 13 - 18
4.5 - 11 150 - 450 AST ALT
1+ Trace Mild swelling Reflexes
x103 HCT x103 5 - 40 7 - 56
F: 36% - 48%
M: 39% - 54%
ALP 2+ Mild 0 No response absent

1+
40 - 120
Moderate Deep Present, but sluggish or diminished
RENAL DIAGRAM 3+ indentation remains
2+ Active or expected response normal
ARTERIAL BLOOD GAS (ABG) for a short time
Ca Mg
Severe Very deep 3+ More brisk than excited; hyperactive
pH PCO2 HCO3 PO2
7.35 - 7.45 35 - 45 22 - 26 80 - 100
9 - 11 1.5 - 2.5
4+ indentation that lasts
4+ Brisk, hyperactive, with intermittent or transient clonus
Phos
a long time
2.5 - 4.5 Weeping edema
© 2023 NurseInTheMaking LLC