Welcome to a comprehensive guide on fundamental nursing topics, designed for easy learning and practical application. This guide breaks down essential concepts section by section with explanations, examples, and key points, focusing on providing practical knowledge and actionable steps you can use in your nursing practice.

Table of Contents:

1. I. Vital Signs
2. II. Hygiene
3. III. Nutrition
4. IV. Elimination
5. V. Medication Administration
6. VI. Mobility and Immobility
7. VII. Wound Care
8. Key Considerations

I. Vital Signs

Vital signs are the cornerstone of patient assessment. They provide a quick snapshot of the patient’s physiological status.

What are Vital Signs?

Temperature, pulse, respiration, blood pressure, and pain (often considered the “fifth vital sign”). Some facilities are beginning to include oxygen saturation as a standard vital sign as well.

Normal Ranges (Adults)

These are general ranges, and variations can occur based on age, health status, and individual circumstances. Always check your facility’s specific guidelines.

Vital Sign	Normal Range
Temperature (Rectal)	98.6°F – 100.6°F (37°C – 38.1°C) – Generally 1 degree higher than oral
Temperature (Oral)	97.6°F – 99.6°F (36.4°C – 37.5°C)
Temperature (Axillary)	96.6°F – 98.6°F (35.9°C – 37°C) – Generally 1 degree lower than oral
Temperature (Tympanic)	Similar to oral, but can be affected by earwax, placement, or improper technique
Temperature (Temporal Artery)	Similar to oral
Pulse (Heart Rate)	60-100 beats per minute (bpm)
Respirations	12-20 breaths per minute
Blood Pressure	Systolic <120 mmHg and Diastolic <80 mmHg
Oxygen Saturation (SpO2)	95-100% on room air (RA). Acceptable ranges may vary based on patient condition, such as COPD, where lower O2 sats can be normal

How to Assess Accurately:

Temperature:

Temperature Measurement Method	Placement Instructions	Duration
Oral	Place under the tongue in the posterior sublingual pocket	About 1 minute (or until the device beeps)
Rectal	Lubricate and insert 1-1.5 inches (adults)	About 2 minutes (or as per thermometer instructions)
Axillary (Armpit)	Place in the dry axilla with the arm pressed against the body	4-5 minutes (mercury) or until digital thermometer beeps
Tympanic (Ear)	Pull the ear up and back (adults) or down and back (children under 3), ensure a tight seal	Few seconds (Instant Read)
Temporal Artery (Forehead)	Scan from the center of the forehead to the temporal artery	Few seconds (Instant Read)

Pulse:

Radial: Use your index and middle fingers (never thumb!) to palpate the radial artery (thumb side of the wrist). Count for 30 seconds and multiply by 2 (for regular rhythms). If irregular, count for a full minute. Assess rate, rhythm (regular or irregular), and strength (bounding, strong, weak, thready).
Apical: Use a stethoscope and listen at the apex of the heart (5th intercostal space, midclavicular line) for a full minute. This is the most accurate method for assessing heart rate.

Respirations:

Observe chest rise and fall. Count for 30 seconds and multiply by 2 (for regular rhythms). If irregular, count for a full minute. Assess rate, depth (shallow, normal, deep), and rhythm (regular or irregular). Note any accessory muscle use or labored breathing. 

Blood Pressure:

Use the correct cuff size (width should be about 40% of the arm circumference). Position the arm at heart level. Place the stethoscope over the brachial artery. Inflate the cuff to about 20-30 mmHg above the point where the pulse disappears. Slowly release the pressure (2-3 mmHg per second). The first Korotkoff sound is the systolic pressure, and the last is the diastolic pressure. Avoid taking BP on an arm with an IV, PICC line, mastectomy, or AV fistula.

Oxygen Saturation:

Apply the pulse oximeter probe to a finger, toe, earlobe, or nose. Ensure good circulation to the site. Factors like nail polish, cold extremities, and poor circulation can affect accuracy.

Factors Affecting Readings:

Temperature:

Exercise, time of day (lower in the morning), hormones (menstrual cycle), illness, environment, age.

Pulse:

Exercise, stress, anxiety, medications, caffeine, fever, pain, dehydration.

Respirations:

Exercise, anxiety, pain, respiratory conditions, medications, body position.

Blood Pressure:

Age, weight, stress, medications, caffeine, smoking, exercise, time of day, race, family history.

Oxygen Saturation:

Altitude, lung disease, anemia, cold extremities, poor circulation.

Interventions for Abnormal Values:

Condition	Types	Range (BP, HR, Blood Sugar)
Hypertension (High BP)	Elevated BP	120–129 / <80 mmHg
	Stage 1 Hypertension	130–139 / 80–89 mmHg
	Stage 2 Hypertension	≥140 / ≥90 mmHg
	Hypertensive Crisis	≥180 / ≥120 mmHg (Emergency)
Hypotension (Low BP)	Mild Hypotension	90–99 / 60–69 mmHg
	Moderate Hypotension	70–89 / 40–59 mmHg
	Severe Hypotension (Shock)	<70 / <40 mmHg
Tachycardia (High HR)	Mild Tachycardia	100–120 bpm
	Moderate Tachycardia	121–150 bpm
	Severe Tachycardia	>150 bpm (Emergency)
Bradycardia (Low HR)	Mild Bradycardia	50–59 bpm
	Moderate Bradycardia	40–49 bpm
	Severe Bradycardia	<40 bpm (May require pacemaker)
Hyperglycemia (High Blood Sugar)	Mild Hyperglycemia	140–199 mg/dL (Postprandial)
	Diabetes (Fasting Glucose)	≥126 mg/dL
	Severe Hyperglycemia (DKA)	>250 mg/dL (Emergency)
Hypoglycemia (Low Blood Sugar)	Mild Hypoglycemia	60–70 mg/dL
	Moderate Hypoglycemia	40–59 mg/dL
	Severe Hypoglycemia	<40 mg/dL (Life-threatening)

1. Hypertension (High Blood Pressure)

• Types:
  • Primary (Essential): No identifiable cause (90-95% of cases).  
  • Secondary: Caused by underlying conditions (kidney disease, endocrine disorders, etc.).  
• Ranges (mmHg):
  • Normal: <120/80  
  • Elevated: 120-129/<80
  • Stage 1 Hypertension: 130-139/80-89  
  • Stage 2 Hypertension: ≥140/≥90  
  • Hypertensive Crisis: >180/>120  
• Relevant Details:
  • “White coat hypertension” can occur in clinical settings.  
  • Lifestyle modifications (diet, exercise) are essential.  
  • Monitor for target organ damage (kidneys, heart, brain).  

2. Hypotension (Low Blood Pressure)

• Ranges (mmHg):
  • Generally <90/60  
• Relevant Details:
  • Causes: Dehydration, medications, heart problems, etc.  
  • Symptoms: Dizziness, lightheadedness, blurred vision.  
  • Monitor for orthostatic hypotension (BP drop upon standing).  

3. Tachycardia (Fast Heart Rate)

• Range (bpm):
  • >100 (adults)  
• Relevant Details:
  • Causes: Anxiety, fever, dehydration, etc.
  • Monitor ECG for arrhythmias.  

4. Bradycardia (Slow Heart Rate)

Pacing may be needed if symptomatic.

Range (bpm):

<60 (adults)  

Relevant Details:

Causes: Medications, electrolyte imbalances, etc.  

Monitor ECG for arrhythmias.

Fever (Elevated Temperature):

Administer antipyretics (e.g., acetaminophen, ibuprofen) as prescribed.
Encourage fluids.
Apply cooling measures: cool compresses, tepid sponge bath (avoid shivering).
Monitor for signs of infection.

Routes for Temperature Taking and Contraindications:

Route	Advantages	Disadvantages	Contraindications
Oral	Easy, convenient, non-invasive	Affected by eating/drinking, may not be accurate in unconscious patients	Oral surgery, seizures, confused patients, infants, uncooperative patients, recent oral intake.
Rectal	Most accurate	Invasive, uncomfortable, time consuming, risk of perforation	Recent rectal surgery, diarrhea, bleeding hemorrhoids, neutropenia (low WBC count).
Axillary	Non-invasive, safe	Least accurate, affected by sweating	Requires longer time, not suitable for critically ill patients.
Tympanic	Quick, easy	Can be affected by earwax, improper technique	Ear infections, ear surgery.
Temporal	Quick, easy, non-invasive	Can be affected by sweating	Scarring on forehead.

II. Hygiene

Hygiene is essential for maintaining comfort, preventing infection, and promoting overall well-being.

Types of Baths:

• Complete Bed Bath: The nurse performs all aspects of bathing for a patient who is completely dependent.
• Partial Bed Bath: The nurse assists with bathing areas the patient cannot reach (e.g., back, legs, feet). The patient washes the areas they can reach (e.g., face, arms, chest).
• Sitz Bath: Cleanses the perineal area, promotes healing after childbirth or rectal surgery. Involves sitting in a tub or basin of warm water.
• Shower/Tub Bath: Patient washes themselves in a shower or tub, with assistance as needed. Requires the patient to be ambulatory and stable.
• Towel Bath/Bag Bath: Uses pre-moistened cloths to cleanse the skin. Useful for patients who are bedridden or have sensitive skin.

Oral Hygiene:

• Conscious Patient: Encourage brushing teeth at least twice a day with a soft-bristled toothbrush. Provide mouthwash (alcohol-free is preferred). Floss daily.
• Unconscious Patient: Position the patient on their side to prevent aspiration. Use a padded tongue blade to gently open the mouth. Clean the teeth and gums with a toothbrush or foam swab moistened with water or a special mouthwash. Use suction to remove secretions.
• Dentures: Clean dentures daily with denture cleaner and a denture brush. Store dentures in water when not in use to prevent drying and cracking.

Skin Care:

Assess skin daily: Look for redness, dryness, breaks in the skin, or signs of infection.
Keep skin clean and dry: Use mild soap and water. Pat skin dry, avoid rubbing.
Apply moisturizers: Especially after bathing, to prevent dryness and cracking.
Avoid harsh chemicals or irritants: Use fragrance-free products.
Protect skin from friction and shear: Use barrier creams, protective dressings, and proper positioning techniques.

Pressure Ulcer Prevention:

Risk Assessment: Use a validated tool like the Braden Scale to assess risk factors for pressure ulcers (mobility, sensory perception, moisture, activity, nutrition, friction/shear).
Repositioning: Turn and reposition patients at least every 2 hours. Use pillows or foam wedges to relieve pressure points.
Pressure-Relieving Devices: Use specialized mattresses, cushions, and heel protectors to reduce pressure.
Skin Care: Keep skin clean and dry. Apply barrier creams to protect against moisture.
Nutrition: Ensure adequate protein and calorie intake to promote skin health and healing.
Hydration: Maintain adequate hydration to keep skin supple.

Pressure Ulcer Staging:

Stage 1: Non-blanchable erythema (redness) of intact skin. Skin is intact.
Stage 2: Partial-thickness skin loss involving the epidermis or dermis. Presents as a shallow open ulcer with a red-pink wound bed, without slough. May also present as an intact or ruptured serum-filled blister.
Stage 3: Full-thickness skin loss involving damage or necrosis of subcutaneous tissue. The ulcer presents as a deep crater with or without undermining of adjacent tissue. Slough may be present but does not obscure the depth of tissue loss.
Stage 4: Full-thickness tissue loss with exposed bone, tendon, or muscle. Slough or eschar may be present. Often includes undermining and tunneling.
Unstageable: Full-thickness tissue loss in which the base of the ulcer is covered by slough (yellow, tan, gray, green, or brown) and/or eschar (tan, brown, or black) in the wound bed.
Deep Tissue Injury (DTI): Purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying soft tissue from pressure and/or shear. The area may be painful, firm, mushy, boggy, warmer, or cooler as compared to adjacent tissue.

Interventions for Pressure Ulcers (Based on Stage):

Stage 1: Relieve pressure, keep skin clean and dry, apply barrier cream, monitor for progression.
Stage 2: Cleanse with normal saline, apply moisture-retentive dressing (hydrocolloid, transparent film), protect surrounding skin.
Stage 3: Debridement (removal of necrotic tissue), wound packing, moisture-retentive dressing, consider negative pressure wound therapy (wound vac).
Stage 4: Debridement, wound packing, consider surgical intervention (flap closure), negative pressure wound therapy.
Unstageable: Debride the wound to expose the base and stage accurately.
DTI: Relieve pressure, protect the area, monitor closely for progression.

Infection Control Practices:

Hand Hygiene: The most important measure to prevent the spread of infection. Wash hands with soap and water for at least 20 seconds, or use an alcohol-based hand sanitizer.
Personal Protective Equipment (PPE): Use gloves, gowns, masks, and eye protection as needed to protect yourself and your patients from exposure to infectious agents.
Standard Precautions: Treat all patients as if they are potentially infectious. Use hand hygiene and PPE when indicated.
Transmission-Based Precautions: Used in addition to standard precautions when a patient has a known or suspected infection. Include contact precautions, droplet precautions, and airborne precautions.
Isolation: Place patients with highly contagious infections in a private room to prevent transmission.
Proper Disposal of Sharps: Use sharps containers to dispose of needles, syringes, and other sharp objects.
Cleaning and Disinfection: Clean and disinfect equipment and surfaces regularly.
Sterilization: Sterilize critical equipment that comes into contact with sterile body tissues.

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III. Nutrition

Nutrition is essential for maintaining health, promoting healing, and preventing complications.

Basic Nutritional Needs:

Macronutrients:

• Carbohydrates: Provide energy. Sources include bread, pasta, rice, fruits, and vegetables.
• Proteins: Build and repair tissues. Sources include meat, poultry, fish, eggs, dairy products, beans, and nuts.
• Fats: Provide energy, insulate the body, and protect organs. Sources include oils, butter, avocados, nuts, and seeds.

Micronutrients:

Vitamins: Essential for various bodily functions.
Minerals: Essential for bone health, nerve function, and other processes.

Water:

Essential for hydration, nutrient transport, and waste removal.

Therapeutic Diets:

Diabetic Diet: Controlled carbohydrate intake, focus on whole grains, lean protein, healthy fats, and plenty of fruits and vegetables. Goal is to maintain stable blood sugar levels.
Low-Sodium Diet: Restricts sodium intake to manage hypertension, heart failure, and kidney disease. Avoid processed foods, canned goods, and salty snacks.
Low-Fat Diet: Restricts fat intake to manage heart disease, gallbladder disease, and other conditions. Focus on lean protein, fruits, vegetables, and whole grains.
Renal Diet: Restricts protein, sodium, potassium, and phosphorus to manage kidney disease.
Cardiac Diet: Low in saturated fat, cholesterol, and sodium. Focus on lean protein, fruits, vegetables, and whole grains.
Clear Liquid Diet: Provides fluids and electrolytes. Includes clear broths, gelatin, clear juices, and popsicles. Used for short-term bowel rest or pre-operative preparation.
Full Liquid Diet: Includes clear liquids plus milk, yogurt, creamed soups, and ice cream. Used as a transition diet after clear liquids.
Mechanical Soft Diet: Foods that are easy to chew and swallow. Includes mashed potatoes, pureed foods, soft fruits, and cooked vegetables.

Feeding Techniques (Dysphagia & Altered Consciousness):

Dysphagia (Difficulty Swallowing):

Position the patient upright (90 degrees) during and after meals.
Provide small, frequent meals.
Thicken liquids to the appropriate consistency (nectar-thick, honey-thick, pudding-thick).
Encourage the patient to tuck their chin to their chest during swallowing.
Monitor for coughing, choking, or wet vocal quality.
Consult with a speech therapist for a swallow evaluation.

Altered Consciousness:

Assess the patient’s ability to swallow before feeding.
Consider alternative feeding methods, such as a nasogastric tube (NG tube), gastrostomy tube (G-tube), or jejunostomy tube (J-tube).
If oral feeding is attempted, position the patient on their side and use a small amount of food at a time.
Monitor for aspiration.

Monitoring Intake and Output (I&O):

Intake: Measure all fluids consumed by the patient, including oral fluids, IV fluids, tube feedings, and medications.
Output: Measure all fluids excreted by the patient, including urine, stool, emesis, wound drainage, and drainage from tubes.
Document I&O accurately: Record the amount and type of fluid in the patient’s chart.
Compare intake and output: Assess for fluid imbalances (fluid overload or dehydration).
Report significant changes in I&O: To the physician or other healthcare provider.

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Color Code	Waste Type	Examples (as per Image/Modified)
Red Bags	Plastics waste	Catheters, injections, syringes, tubings I.V., bottles.
Blue Bags	Glass and Discarded Medicines	All types of glass bottles and articles, outdated & discarded medicines.
Yellow Bags	Infectious Waste and Human/Animal Waste	Bandages, gauzes, cotton, body fluids, human body parts, placenta.
Black Bags	General Waste	Wrappers, food stuff, paper.
White Containers	Sharps Disposal	Needles, syringes, blades, broken ampules.

IV. Elimination

Elimination refers to the excretion of waste products from the body.

Bowel and Bladder Elimination Patterns:

Normal Bowel Patterns: Vary depending on individual factors, such as diet, fluid intake, activity level, and medications. Normal stool is brown, formed, and passed without difficulty.
Normal Bladder Patterns: Most adults void 5-6 times per day. Normal urine is clear, yellow, and has a characteristic odor.
Assess: Frequency, color, consistency, amount, odor, and any associated symptoms (pain, straining, urgency).

Catheter Care:

Insertion: Requires sterile technique. Use the correct size catheter. Lubricate the catheter. Insert gently until urine flows. Advance the catheter another 1-2 inches and inflate the balloon.
Maintenance:
Clean the perineal area daily with soap and water.
Keep the catheter drainage bag below the level of the bladder.
Ensure the catheter tubing is free of kinks.
Secure the catheter to the patient’s leg to prevent traction.
Empty the drainage bag regularly.

Removal: Deflate the balloon completely. Gently remove the catheter. Monitor the patient for urinary retention after removal.

Type of Catheter	Size (French Gauge – Fr)	Material	Usage Duration	Common Uses
Foley Catheter (Indwelling)	12-24 Fr	Latex, Silicone	Short to long-term	Used for patients unable to urinate on their own, post-surgery, or with urinary retention.
Suprapubic Catheter	14-24 Fr	Silicone	Long-term	Inserted through the abdominal wall into the bladder, used for chronic urinary retention.
Intermittent (Robinson) Catheter	8-18 Fr	Rubber, PVC	Short-term	Used for temporary drainage, self-catheterization, or after surgery.
External (Condom) Catheter	N/A	Silicone, Latex	Daily replacement	Used for male patients with incontinence to collect urine externally.
Central Venous Catheter (CVC)	4-9 Fr	Polyurethane, Silicone	Medium to long-term	Used for chemotherapy, long-term IV therapy, or critical care.
Hemodialysis Catheter	10-16 Fr	Polyurethane	Temporary	Used for patients requiring dialysis access for blood filtration.
PICC Line (Peripherally Inserted Central Catheter)	4-7 Fr	Polyurethane, Silicone	Weeks to months	Used for long-term IV therapy, antibiotics, chemotherapy.

Enemas:

Types:
Cleansing Enemas: Stimulate bowel evacuation. Include tap water enemas, saline enemas, soap suds enemas, and hypertonic enemas (Fleet enema).
Retention Enemas: Retained in the bowel for a period of time. Include oil retention enemas (lubricate the stool) and medicated enemas.

Administration: Position the patient on their left side (Sims’ position). Lubricate the enema tip. Insert the tip gently into the rectum (3-4 inches in adults). Slowly instill the solution. Encourage the patient to retain the solution for the prescribed amount of time.

Management of Incontinence:

Urinary Incontinence:
Types: Stress incontinence, urge incontinence, overflow incontinence, functional incontinence.
Interventions: Pelvic floor exercises (Kegel exercises), bladder training, scheduled voiding, medications (anticholinergics), absorbent products, intermittent catheterization, surgical interventions.

Fecal Incontinence:
Interventions: Bowel training, dietary modifications (increase fiber), medications (antidiarrheals or stool softeners), absorbent products, skin care, surgical interventions.

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V. Medication Administration

Safe medication administration is a critical nursing responsibility.

The “Rights” of Medication Administration:

Right Patient: Verify the patient’s identity using two identifiers (name, date of birth, medical record number).
Right Medication: Check the medication order and the medication label carefully.
Right Dose: Calculate the correct dose. Double-check calculations with another nurse.
Right Route: Administer the medication by the prescribed route.
Right Time: Administer the medication at the correct time.
Right Documentation: Document the medication administration immediately after giving it.
Right Reason: Know why the patient is receiving the medication.
Right Response: Monitor patient closely: For signs and symptoms of adverse reactions.

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Patient Rights	Description
Right to Informed Consent	Patients have the right to be fully informed about their medical condition, treatment options, risks, and benefits before making decisions.
Right to Privacy and Confidentiality	Personal health information must be kept private, and medical records should only be shared with authorized individuals.
Right to Respect and Dignity	Patients must be treated with respect, regardless of their background, ethnicity, religion, or financial status.
Right to Access Medical Records	Patients have the right to view and obtain copies of their medical records upon request.
Right to Participate in Decision-Making	Patients can take part in planning their healthcare and making choices about treatment options.
Right to Refuse Treatment	Patients have the right to refuse any medical treatment or procedure, even if it may be life-saving.
Right to Emergency Care	Every patient has the right to receive emergency medical care, regardless of their ability to pay.
Right to Pain Management	Patients have the right to appropriate assessment and management of pain.
Right to Complain	Patients can file complaints about their treatment and care without fear of retaliation.
Right to Choose a Healthcare Provider	Patients have the right to select their doctors, specialists, and hospitals.

VI. Mobility and Immobility

Mobility is the ability to move freely and easily. Immobility can lead to numerous complications.

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VII. Wound Care

Wound care is essential for promoting healing and preventing infection.

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Type of Cannula	Size (Gauge)	Color Code	Outer Diameter (mm)	Flow Rate (mL/min)	Common Uses
Neonatal Cannula	26G	Purple	0.45 mm	13 mL/min	Used for neonates, premature babies, and very fragile veins.
Pediatric Cannula	24G	Yellow	0.56 mm	20 mL/min	Used in pediatrics, small fragile veins, and elderly patients.
Small Vein Cannula	22G	Blue	0.72 mm	35 mL/min	Suitable for elderly patients, antibiotics, and long-term medications.
Standard IV Cannula	20G	Pink	0.90 mm	65 mL/min	Used for blood transfusion, IV fluids, and most hospital patients.
Large Vein Cannula	18G	Green	1.30 mm	105 mL/min	Used in trauma, surgeries, rapid fluid resuscitation, and blood transfusions.
High Flow Cannula	16G	Grey	1.70 mm	200 mL/min	Used in emergency settings, surgery, and massive blood transfusion.
Massive Transfusion Cannula	14G	Orange	2.10 mm	300 mL/min	Used for major trauma, emergency resuscitation, and ICU cases.
Nasal Cannula	N/A	Clear	N/A	Oxygen Flow: 1-6 L/min	Used for oxygen therapy in patients with respiratory distress.

SN	Drug Name	Dosage (Typical)	Route	Uses (Indications)	Side Effects	Mode of Action	Category
1	Epinephrine	0.3-0.5 mg IM/IV	IM/IV	Anaphylaxis, cardiac arrest	Tachycardia, hypertension, anxiety, tremors	Adrenergic agonist (alpha & beta)	Emergency
2	Atropine	0.5 mg IV	IV	Bradycardia, antidote for organophosphate poisoning	Tachycardia, dry mouth, blurred vision, urinary retention	Anticholinergic	Emergency
3	Naloxone	0.4-2 mg IV/IM/IN	IV/IM/IN	Opioid overdose	Nausea, vomiting, withdrawal symptoms, tachycardia	Opioid antagonist	Emergency
4	Adenosine	6-12 mg IV	IV	Supraventricular tachycardia (SVT)	Flushing, chest pain, shortness of breath, bradycardia	Slows conduction through AV node	Emergency
5	Amiodarone	300 mg IV	IV	Ventricular arrhythmias, atrial fibrillation/flutter	Hypotension, bradycardia, QTc prolongation, thyroid dysfunction	Potassium channel blocker, sodium channel blocker, beta-adrenergic blocker	Cardiovascular
6	Ceftriaxone	1-2 g IV/IM	IV/IM	Pneumonia, meningitis, sepsis, gonorrhea	Diarrhea, rash, elevated liver enzymes, allergic reactions	Inhibits bacterial cell wall synthesis (beta-lactam)	Antimicrobial
7	Vancomycin	15-20 mg/kg IV	IV	MRSA, C. difficile (oral)	Nephrotoxicity, ototoxicity, red man syndrome, hypotension	Inhibits bacterial cell wall synthesis (glycopeptide)	Antimicrobial
8	Piperacillin/Tazobactam	3.375-4.5 g IV	IV	Broad-spectrum bacterial infections	Diarrhea, rash, elevated liver enzymes, allergic reactions	Inhibits bacterial cell wall synthesis (beta-lactam/beta-lactamase inhibitor)	Antimicrobial
9	Azithromycin	500 mg PO day 1, 250 mg PO days 2-5	PO	Community-acquired pneumonia, chlamydia	Nausea, vomiting, diarrhea, abdominal pain, QTc prolongation	Inhibits bacterial protein synthesis (macrolide)	Antimicrobial
10	Ciprofloxacin	400 mg IV/ 500 mg PO	IV/PO	UTI, pneumonia, abdominal infections	Nausea, vomiting, diarrhea, tendon rupture, QTc prolongation	Inhibits bacterial DNA replication (fluoroquinolone)	Antimicrobial
11	Morphine	2-10 mg IV/IM/SC	IV/IM/SC	Moderate to severe pain	Respiratory depression, constipation, nausea, hypotension	Opioid agonist (mu receptor)	Analgesic
12	Fentanyl	25-100 mcg IV/IM	IV/IM	Moderate to severe pain, anesthesia	Respiratory depression, constipation, nausea, hypotension	Opioid agonist (mu receptor)	Analgesic
13	Hydromorphone	0.2-1 mg IV/IM	IV/IM	Moderate to severe pain	Respiratory depression, constipation, nausea, hypotension	Opioid agonist (mu receptor)	Analgesic
14	Acetaminophen	325-650 mg PO q4-6h	PO	Mild to moderate pain, fever	Liver toxicity (with high doses), rash	Inhibits prostaglandin synthesis in CNS	Analgesic
15	Ibuprofen	200-800 mg PO q6-8h	PO	Mild to moderate pain, inflammation, fever	GI upset, renal toxicity, increased bleeding risk	Inhibits prostaglandin synthesis (NSAID)	Analgesic
16	Ketorolac	15-30 mg IV/IM , 10mg PO	IV/IM/PO	Mild to moderate pain, inflammation	GI upset, renal toxicity, increased bleeding risk	Inhibits prostaglandin synthesis (NSAID)	Analgesic
17	Metoprolol	25-100 mg PO BID	PO	Hypertension, angina, heart failure, atrial fibrillation	Bradycardia, hypotension, fatigue, dizziness	Beta-adrenergic blocker (selective beta-1)	Cardiovascular
18	Lisinopril	10-40 mg PO daily	PO	Hypertension, heart failure, post-MI	Hypotension, cough, angioedema, hyperkalemia	ACE inhibitor	Cardiovascular
19	Amlodipine	5-10 mg PO daily	PO	Hypertension, angina	Peripheral edema, headache, flushing, dizziness	Calcium channel blocker (dihydropyridine)	Cardiovascular
20	Digoxin	0.125-0.25 mg PO daily	PO	Heart failure, atrial fibrillation	Bradycardia, nausea, vomiting, visual disturbances, arrhythmias	Inhibits Na+/K+ ATPase, increasing intracellular calcium	Cardiovascular
21	Furosemide	20-80 mg PO/IV daily	PO/IV	Heart failure, edema	Hypokalemia, hypotension, dehydration, ototoxicity	Loop diuretic (inhibits Na+/K+/2Cl- cotransporter)	Cardiovascular
22	Atorvastatin	10-80 mg PO daily	PO	Hyperlipidemia	Myalgia, elevated liver enzymes, rhabdomyolysis	HMG-CoA reductase inhibitor (statin)	Cardiovascular
23	Nitroglycerin	0.4mg sublingual PRN, IV drip	SL, IV	Angina pectoris, hypertensive crisis, heart failure	Headache, hypotension, dizziness, flushing	Vasodilator (converted to nitric oxide, increasing cGMP)	Cardiovascular
24	Warfarin	Dosage based on INR	PO	Atrial fibrillation, DVT/PE, prosthetic heart valves	Bleeding, bruising, drug interactions	Vitamin K antagonist (inhibits synthesis of clotting factors)	Anticoagulant
25	Heparin	5000 units SC BID/TID, or IV drip	SC/IV	DVT/PE, acute coronary syndrome	Bleeding, thrombocytopenia (HIT)	Activates antithrombin III, inhibiting clotting factors	Anticoagulant
26	Enoxaparin	1 mg/kg SC BID or 1.5 mg/kg daily	SC	DVT/PE, acute coronary syndrome	Bleeding, thrombocytopenia	Low molecular weight heparin (activates antithrombin III)	Anticoagulant
27	Rivaroxaban	10-20 mg PO daily	PO	Atrial fibrillation, DVT/PE	Bleeding	Factor Xa inhibitor	Anticoagulant
28	Apixaban	2.5-5 mg PO BID	PO	Atrial fibrillation, DVT/PE	Bleeding	Factor Xa inhibitor	Anticoagulant
29	Clopidogrel	75 mg PO daily	PO	Acute Coronary syndrome, after stent placement, secondary prevention of stroke/MI	Bleeding	Inhibits platelet aggregation	Antiplatelet
30	Aspirin	81 mg PO daily	PO	Acute Coronary syndrome, after stent placement, secondary prevention of stroke/MI	Bleeding, GI upset	Inhibits platelet aggregation	Antiplatelet
31	Albuterol	2.5 mg nebulized q4-6h PRN	Neb	Asthma, COPD (bronchospasm)	Tachycardia, tremors, anxiety	Beta-adrenergic agonist (selective beta-2)	Respiratory
32	Ipratropium	500 mcg nebulized q6-8h PRN	Neb	COPD, asthma (bronchospasm)	Dry mouth, blurred vision, urinary retention	Anticholinergic (bronchodilator)	Respiratory
33	Fluticasone	50-250 mcg inhaled BID	Inhaled	Asthma (long-term control)	Oral candidiasis (thrush), hoarseness	Corticosteroid (anti-inflammatory)	Respiratory
34	Prednisone	20-60 mg PO daily	PO	Asthma exacerbation, COPD exacerbation	Elevated blood sugar, mood changes, increased appetite, fluid retention	Corticosteroid (anti-inflammatory)	Respiratory
35	Montelukast	10 mg PO daily	PO	Asthma (long-term control), allergic rhinitis	Headache	Leukotriene receptor antagonist	Respiratory
36	Pantoprazole	40 mg PO/IV daily	PO/IV	GERD, PUD, stress ulcer prophylaxis	Headache, diarrhea, C. difficile infection	Proton pump inhibitor (PPI)	GI
37	Ondansetron	4-8 mg IV/PO q8h PRN	IV/PO	Nausea, vomiting	Headache, constipation, QTc prolongation	Serotonin (5-HT3) receptor antagonist	Gastrointestinal
38	Metoclopramide	5-10 mg IV/PO q8h PRN	IV/PO	Nausea, vomiting, gastroparesis	Drowsiness, extrapyramidal symptoms (EPS), QTc prolongation	Dopamine antagonist (prokinetic)	Gastrointestinal
39	Lactulose	15-30 mL PO daily/BID	PO	Constipation, hepatic encephalopathy	Diarrhea, abdominal cramping	Osmotic laxative, reduces ammonia levels	Gastrointestinal
40	Polyethylene Glycol (Miralax)	17 g PO daily	PO	Constipation	Diarrhea, abdominal cramping	Osmotic laxative	Gastrointestinal
41	Haloperidol	2-5 mg IM/PO q4-8h PRN	IM/PO	Acute psychosis, agitation	Extrapyramidal symptoms (EPS), QTc prolongation, sedation	Dopamine antagonist (typical antipsychotic)	Psychiatric
42	Lorazepam	0.5-2 mg IV/IM/PO q6-8h PRN	IV/IM/PO	Anxiety, agitation, seizures, alcohol withdrawal	Sedation, respiratory depression, hypotension	Benzodiazepine (GABA agonist)	Psychiatric
43	Sertraline	25-200 mg PO daily	PO	Depression, anxiety disorders, OCD	Nausea, diarrhea, sexual dysfunction, insomnia	Selective serotonin reuptake inhibitor (SSRI)	Psychiatric
44	Quetiapine	25-800 mg PO daily/BID	PO	Bipolar disorder, Schizophrenia	Sedation, weight gain, metabolic syndrome	Atypical Antipsychotic (Dopamine antagonist)	Psychiatric
45	Trazodone	50-150 mg PO HS	PO	Insomnia, depression	Sedation, orthostatic hypotension	Serotonin antagonist and reuptake inhibitor (SARI)	Psychiatric
46	Insulin Lispro	Dosage varies (SC before meals)	SC	Type 1 and Type 2 Diabetes (mealtime insulin)	Hypoglycemia	Rapid-acting insulin analog	Endocrine
47	Insulin Glargine	Dosage varies (SC daily)	SC	Type 1 and Type 2 Diabetes (basal insulin)	Hypoglycemia	Long-acting insulin analog	Endocrine
48	Metformin	500-2000 mg PO daily/BID	PO	Type 2 Diabetes	Nausea, diarrhea, lactic acidosis (rare)	Decreases hepatic glucose production, increases insulin sensitivity	Endocrine
49	Levothyroxine	Dosage varies (PO daily)	PO	Hypothyroidism	Tachycardia, anxiety, tremors, heat intolerance	Synthetic T4 (thyroid hormone)	Endocrine
50	Dextrose 50%	25-50 mL IV	IV	Hypoglycemia	Hyperglycemia, tissue necrosis (if extravasation)	Increases blood glucose levels	Endocrine
51	Propofol	Dosage varies (IV infusion)	IV	Anesthesia induction and maintenance, sedation	Hypotension, respiratory depression, bradycardia	GABA agonist	Anesthetic
52	Midazolam	1-5 mg IV	IV	Sedation, anxiolysis, anesthesia induction	Respiratory depression, hypotension, amnesia	Benzodiazepine (GABA agonist)	Anesthetic
53	Succinylcholine	1-1.5 mg/kg IV	IV	Rapid sequence intubation (paralysis)	Malignant hyperthermia, hyperkalemia, bradycardia	Depolarizing neuromuscular blocker	MuscleRelaxant
54	Rocuronium	0.6-1.2 mg/kg IV	IV	Paralysis for intubation or surgery	Prolonged paralysis, bradycardia, hypotension	Nondepolarizing neuromuscular blocker	MuscleRelaxant
55	Vecuronium	0.08-0.1 mg/kg IV	IV	Paralysis for intubation or surgery	Prolonged paralysis, bradycardia, hypotension	Nondepolarizing neuromuscular blocker	MuscleRelaxant
56	Potassium Chloride	Dosage varies (PO/IV)	PO/IV	Hypokalemia	Hyperkalemia, cardiac arrhythmias, infusion site pain	Replaces potassium deficiency	Electrolyte
57	Magnesium Sulfate	Dosage varies (IV/IM)	IV/IM	Hypomagnesemia, pre-eclampsia/eclampsia, torsades de pointes	Hypotension, respiratory depression, decreased reflexes	Replaces magnesium deficiency, CNS depressant	Electrolyte
58	Calcium Gluconate	Dosage varies (IV)	IV	Hypocalcemia, hyperkalemia, hypermagnesemia	Hypotension, bradycardia, decreased reflexes	Replaces calcium deficiency	Electrolyte
59	Famotidine	20mg IV/PO BID	IV/PO	Stress Ulcer prophylaxis	Headache, dizziness	H2 receptor antagonist	GI
60	Promethazine	12.5-25 mg IV/IM/PO q4-6h PRN	IV/IM/PO	Nausea, vomiting, Allergic reaction	Sedation, Extrapyramidal symptoms (EPS), tissue necrosis	H1 receptor antagonist	GI
61	Diphenhydramine	25-50 mg IV/IM/PO q4-6h PRN	IV/IM/PO	Allergic reaction, Insomnia	Sedation, dizziness	H1 receptor antagonist	Antihistamine
62	Docusate	100 mg PO Daily	PO	Constipation	Abdominal cramping, Diarrhea	Stool Softener	GI
63	Polyethylene Glycol (GoLYTELY)	4L solution, given PO or via NG tube	PO	Bowel prep prior to procedure	Abdominal cramping, bloating, nausea, vomiting	Osmotic agent	GI
64	Labetalol	20 mg IVP then titrate to effect	IV	Hypertensive emergency	Hypotension, Bradycardia	Beta-blocker and Alpha blocker	Cardiovascular
65	Hydralazine	10-20 mg IVP or IM	IV/IM	Hypertensive emergency	Hypotension, Tachycardia	Vasodilator	Cardiovascular
66	Norepinephrine (Levophed)	2-4 mcg/min and titrate	IV	Sepsis or other causes of shock	Peripheral vasoconstriction, elevated heart rate, hypertension, limb ischemia	Vasopressor	Cardiovascular
67	Vasopressin	0.03 Units/min	IV	Sepsis or other causes of shock	Peripheral vasoconstriction, elevated heart rate, hypertension, limb ischemia	Vasopressor	Cardiovascular
68	Diltiazem	10-20 mg IV then oral drip or PO option	IV/PO	A-Fib Rate control	Hypotension, Bradycardia	Calcium channel blocker	Cardiovascular
69	Bumetanide	1 mg IV/PO	IV/PO	Heart Failure, Edema	Hypotension, electrolyte imbalances	Loop Diuretic	Cardiovascular
70	Spironolactone	25-50 mg PO Daily	PO	Heart Failure, Edema, Ascites	Hypotension, electrolyte imbalances	Aldosterone Antagonist (Potassium Sparing Diuretic)	Cardiovascular
71	Mannitol	.25-.5g/kg IV bolus, then infuse	IV	Increased intracranial pressure	Hypotension, electrolyte imbalances	Osmotic diuretic	Neuro
72	Diazepam	5-10mg IV/PO	IV/PO	Seizure, anxiety	Hypotension, respiratory depression	Benzodiazepine	Neuro
73	Levetiracetam (Keppra)	500-1500 mg IV/PO	IV/PO	Seizure prophylaxis/treatment	fatigue, dizziness, confusion	Anticonvulsant	Neuro
74	Ceftazidime	1-2 g IV q8-12	IV	Gram negative infections, pseudomonas	Headache, Diarrhea	Cephalosporin Antibiotic	Antimicrobial
75	Meropenem	500mg-1g IV Q8	IV	Severe infections resistant to other antibiotics	Headache, Diarrhea	Carbapenem Antibiotic	Antimicrobial
76	Clindamycin	300-900 mg IV/PO Q6-8	IV/PO	Gram + infections, anaerobes	Diarrhea, C. Diff	Lincosamide Antibiotic	Antimicrobial
77	Fluconazole	200-400mg IV/PO Daily	IV/PO	Fungal infections, candidiasis, cryptococcus	Headache, Liver enzyme abnormalities	Antifungal	Antimicrobial
78	Valacyclovir	1g PO BID	PO	HSV, Varicella Zoster	Headache, Liver enzyme abnormalities	Antiviral	Antimicrobial
79	Oseltamivir (Tamiflu)	75mg PO BID	PO	Influenza A or B	Headache, Nausea, Vomiting	Antiviral	Antimicrobial
80	Trimethoprim/Sulfamethoxazole (Bactrim)	1-2 Tabs PO BID or IV q12	IV/PO	UTI, MRSA skin infections, pneumocystis pneumonia	Rash, Photosensitivity	Sulfa Antibiotic	Antimicrobial
81	Fidaxomicin (Dificid)	200 mg PO BID	PO	C. Diff	Nausea Vomiting	Macrolide Antibiotic	GI
82	Rifampin	600 mg PO Daily	PO	TB, prosthetic joint infections	Headache, Liver enzyme abnormalities, Turns bodily fluid orange	Broad spectrum antibiotic	Antimicrobial
83	Dexamethasone	4-8mg IV/PO Q6	IV/PO	Swelling, inflammation, allergic reactions, Asthma/COPD exacerbation, Nausea	Mood changes, increased blood sugar, immune suppression, Increased appetite	Corticosteroid	Respiratory
84	Methylprednisolone	40-125 mg IV/PO q6	IV/PO	Swelling, inflammation, allergic reactions, Asthma/COPD exacerbation, Nausea	Mood changes, increased blood sugar, immune suppression, Increased appetite	Corticosteroid	Respiratory
85	Haloperidol	2-5 mg IM/PO q4-8h PRN	IM/PO	Acute psychosis, agitation	Extrapyramidal symptoms (EPS), QTc prolongation, sedation	Dopamine antagonist (typical antipsychotic)	Psychiatric
86	Nalbuphine	10-20 mg IV/IM/SC q3-6 prn	IV/IM/SC	Moderate to severe pain	Sedation, respiratory depression, nausea, vomitting	Opioid partial

Key Considerations

Documentation is Crucial: Document all assessments, interventions, and patient responses accurately and completely.

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This comprehensive guide provides a solid foundation in these fundamental nursing concepts. Remember to practice these skills under the supervision of an experienced nurse to gain confidence and competence. Good luck! Let me know if you have any specific questions about any of these topics!