Clinical Readiness Test

Normal Values: Temperature

Oral = 96.8-100.4 F

Normal Values: Heart Rate/Pulse

60-100 bpm

Normal Values: Respiratioms

12-20 bpm/breaths

Normal Values: Blood Pressure w/ systolic and diastolic

Normal =  Less than 120 / Less than 80 

Elevated Ranges: Blood Pressure

Elevated = 120-129 / Less than 80 

Stage 1 = 130-139/80-89 

Stage 2 =  >140/>90 

HTN Emergency: Higher than 180 / Higher than 120 

Normal Ranges: Oxygen Saturation

SpO2 of 95-100% on RA (room air)  

May be (e.g., > 93%) in post op patients

COPD patients may also have range orders, but the patient’s “normal” might be lower than the normal range

Always document oxygen saturation with oxygen delivery device and flow rate (e.g., “NC at 3 lpm”) or as RA 

Normal Ranges: Capillary Refill

< 3 seconds

Normal Value: Urine Output

Minimum urine output to perfuse all organs:  30 ml/hr 

Stethoscope Placement for lungs, heart, abdomen, order of assessment, and lung sounds⭐

Lungs: 9 rows on the back, 6 rows on the front

Heart: 5 points

Abdomen: 4 points, start with the RQL, auscultate before palpation

Purpose of an NG Tube

To decompress (drain) the stomach

To administer tube feedings (enteral feedings)

Purpose of an Urinary Catheter

To monitor fluid status (this is the main reason in the acute care settings

To treat urinary retention

To manage urinary incontinency only if it affects the patient’s integumentary system

Purpose of the JP drain

To drain excess fluid from a wound bed in order to prevent a hermatoma or seroma

Purpose of the Chest Tube

To drain air and fluid from the pleural cavity after a pneumothorax, hemothorax, or lung surgery

What is the purpose of a tracheostomy tube?

to create an artificial airway to upper airway obstruction or weak respiratory drive requiring assistive ventilation

Define PERRLA

Pupils are Round, Reactive, and Light Accomodating

Purpose is to assess Optic Nerve (II) and Oculomotor Nerve (III)

Define Rales

abnormal clicking, rattling, or popping lung sounds

Define Rhonchi

abnormal, low-pitched, continuous rattling breath sounds that sound like snoring or gurgling

Define Wheezes

high pitched whistling sound

Define Crackles

abnormal, popping, or bubbling lung sounds

What are examples of adventitious breath sounds

Rales, Rhonchi, Wheezes, Crackles

What does ROM stand for?

Range of Motion

What does PRN mean?

as needed

What does LPM stand for?

liters per minute

What does AC mean?

before meals

What does HS mean?

hours of sleep/bedtime

t or tsp mean?

teaspoon

T or tbsp

tablespoon

What does OOB stand for

out of bed

What is ERBs point

left of the sternum at the third intercostal space

What is aortic area

2nd intercostal space, right sternal border

What is Pulmonic area

2nd intercostal space, left sternal border

Tricuspid area

4th intercostal space, left lower sternal border

Mitral area (apical)

5th intercostal space, left midclavicular line

Review med math/conversions

1 tsp = 5 mL

1 tbsp = 15 mL

1 oz = 30 mL

1 cup = 8 oz = 240 mL

2.2 lbs = 1 kg

C = (F - 32) / 1.8

F = (C x 1.8) + 32

Normal Range for Sodium

136-145

Normal Range for Potassium

3.5-5.0 mEq/L

Normal Range for Calcium

9-10.5 mg/dL

Normal Range for Bicarbonate

22-26

Normal Range for BUN

9-23

BUN = blood urea nitrogen

Normal Range for Creatinine

0.55-1.02

Normal Range for Magnesium

1.3-2.1

Normal Range for Chloride

98-106

Normal Range for Red Blood Cells for CBC

4.7-6.1 males million cells/mcL

4.2-5.4 females million cells/mcL

Normal Range for Hemoglobin

11-18 g/dL males

12-16 g/dL females

Normal Range for Hematocrit

32-44%

Normal Range for White Blood Cells

5-10% of total CBC

Normal Range for Neutrophils

40-75% of total WBC

Normal Range for Lymphocytes

20-50% of total WBC

Normal Range for Monocytes

2-12% of total CBC

Normal Range for Eosinophils

0-3% of total CBC

Normal Range for Basophils

0-2% of total CBC

Normal Range for Bands

0-6%

Normal Range for Platelets

150-400k per microliter of blood

Normal Range for PT (prothrombin time)

11-12.5

Normal Range for aPTT (ctivated partial thromboplastin time)

30-40

Normal Range for AST

10-40

Normal Range for ALT

7-56

Normal Range for CO2

35-45 mmHg

Normal Range for Bilirubin

Total: 0.2-1.2

Normal Value for BNP

<100

Normal Findings for Adult INR - international normalized ratio

0.8-1.2

Desirable Cholesterol Levels

<200

Desirable HDL - high density cholesterol

men >45

female >55

Desirable LDL

<100

Desirable triglycerides

<150

Normal troponin

<0.3

if increased: myocardial infarction (MI), myocardial damage post cardiac surgery

Normal Urine Characteristics

Color: pale, yellow (straw-colored)

Appearace: Clear to slightly hazy

Urine Specific Gravity: 1.005-1.030

pH: 4.6-8

Protein: <20 mg/dl

Glucose: Negative

Ketones: Negative

Bilirubin: Negative

Abnormal Color in Urine Meaning

Dark Yellow- may indicated dehydration, food, medication, or metabolic by products may alter urine color

Pink/red: blood or food related

Neon orange: PO intake of Pyridium

Dark orange/brown: kidney failure, rhabdomyolysis, liver failure

Colorless: over hydration

Abnormal appearance in urine may indicate

Cloudy appearance may be due to bacterial infection, semen, vaginal discharge, or ingestrion of certain foods or supplements

Abnormal Urine Specific Gravity may indicate

High: heart failure, dehydration, diabetes, nephritix syndrome, SIADH

Low: chronic renal failure, diabetes inspidus, glomerulonephritis

Abnormal range in pH in urine may indicate

High may be due to citrus fuits, alkalosis, vegetarian diet

Low may be due to high protein ingestion, fruits (cranberries), acidosis

High protein in urine may indicate

diabetic nephropathy, glomerulonephritis, toxemia, of pregnancy, stress, exercise

High glucose in urine may indicate

diabetes, Cushing’s syndrome, acromegly

High ketones in urine may indicate

acute illness, diabetes, diabetic ketoacidosis, fasting, high-protein diet, post anesthesia vomiting, strenuous exercise

High bilirubin in urine may indicate

Cirrhosis, hepatitis, hepatic tumor, obstructive biliary disease