Group4E

1. Newly Qualified Nurses
Survival Guide
Group 4E

2. Content Page
Title Slide
Tips for newly qualified nurse............3
List of Abbreviations.........................4-5
Normal ranges......................................6
Analgesic Pain scale.............................7
Emergency Protocols.............................9
Drug Calculations................................10
Waterlow guidelines.........................11-15
ECG leads Placement .........................16

3. Tips For Newly Qualified Nurses
It is advisable to have fob watch (not on your wrist!) with a second
hand for three main reasons:
Telling the time
Punctuality
And taken patients pulse
Need to make sure you have a pen (preferably black). NMC guidelines
for records and record keeping” (2004) only recommends that notes
can be “readable on any photocopies”.
Its a good idea to purchase your own stethoscope.
Get a drug book e.g. a BNF to get use to the main drugs used on the

4. List of abbreviations
ABG – arterial blood gas CRP- Cardiopulmonary resuscitation
AC- before food Cr- creatinine
ADH- antidiuretic hormone CSF- cerebrospinal fluid
AIDS- acquired immune deficiency CVC- central venous catheter
Syndrome CVP- central venous pressure
ARDS- acute respiratory distress DNAR- do not attempt resuscitation
syndrome DVT- deep vein thrombosis
ARF- acute renal failure ECG- electrocardiogram
AV- atrioventricular FWB- full weight bearing
BD- twice daily GCS- Glasgow coma scale
BMI- body mass index GFR- glomerular filtration rate
BP- blood pressure GI- gastrointestinal
BUN- blood urea nitrogen GUTT- eye drops
CDs- controlled drugsCNS- central HNIg- Human normal immunoglobulin
nervous system HLV- human lymphoma virus
CO- Cardiac output or Carbon monoxide IC- inspiratory capacity
CO2- carbon dioxide IDDM- insulin-dependent
COPD- chronic obstructive pulmonary
disease

5. IM- intramusclar PO- by mouth
IV- intravenous POM- prescribed only medication
MAP- mean arterial pressure PR- per rectum
MI- myocardial infarction PRN- as required
MRSA- methicillin resistant PV- per vagina
staphylococcus aureus QDS- four times daily
NG- nasogastric QQH- every four hours
NSAID- non- steroidal anti RV- residual volume
inflammatory drug SCC- spinal cord compression
NWB- non weight bearing SI- sublingual
OCC- eye cream STAT- immediately
OM- every morning SUB CUT- subcutaneous
ON- every night TB- tuberculosis
P- Pharmacy medicines TEDS- thromboembolic deterrent
PaCO2- partial pressure of carbon dioxide stocking
PC- after food TDS/ TLD- three times daily
PCA- patient controlled analgesic TLC- total lung capacity
PEG- percutaneous endoscopically placed VF- ventricular fibrillation
gastrostomy

6. Normal Ranges
Normal Pulse Rates Temperature
New born 120 – 160 Armpit: 34.7oC to 37.3oC
1 – 2 months 80 – 140 Mouth: 35.5oC to 37.5oC
1 – 2 years 80-130 Ear: 35.8oC to 38oC
2 – 6 years 75 – 120
6 – 12 years 75- 110
12 – adult 60 – 100 Normal Bloods Values
Biochemistry
Abumin 35 – 50 g/l
Average Blood Pressure Amylase 25 – 125 u/l
1 year 95/65 Bicarbonate 22 – 30 mmol/l
6 – 9 years 100/65 Bilirubin 3 – 17 mmol/l
Adult 110/65 – 140/90 Calcuim 2.12 – 2.67 mmol/l
Average Respiratory Rate Cholesterol 3.5 – 6.5 mmol/l
Newborn 30 – 80/min Creatinine 70 – 150 mmol/l
Early childhood 20 – 40/min Glucose 3.6 – 5.5 mmol/l
Late childhood 15 – 18/min Potassium 3.5 – 5.0 mmol/l
Adulthood 16 – 20/min Sodium 136 – 138 mmol/l"
Urea 2.5 – 6.7"
Normal Adult Urine Values
Output/24 hours 1000 – 15000 mls Haematology
PH 6 Haemoglobin (Hb)
Specific Gravity 1.001 – 1.035 Male 13.5 – 17.7 g/dl Female 11.5 – 16.5 g/dl
White Blood Count (WBC) 4 – 11 x 109/L
Platelet count 150- 400 x10g/l
Oxygen Saturation level above 95% " " " " " " "
" " " " "

7. Analgesic Pain Scale

8. Guidelines for
Analgesic Pain Scale
Mild pain: Step 1: Simple analgesics (non-opioid)
Initiate topical and/or simple oral non-opioid analgesics (e.g. paracetamol, NSAIDs)
+ adjuvant e.g. tricyclic antidepressants, anticonvulsants (pregabalin or gabapentin) for
neuropathic pain.
Moderate pain: Step 2: Weak opioid
Weak opioid (e.g. tramadol, codeine phosphate or dextropropoxyphene)
+ adjuvant e.g. tricyclic antidepressants, anticonvulsants
Severe pain: Step 3: Strong opioid
Opioids (e.g. morphine, oxycodone)
+ adjuvant e.g. tricyclics, anticonvulsants

9. Emergency Protocols
First Response of finding • Start chest compressions if no
patient. sign of response.
• A=Airway • Have crash trolley in position with
Checking patient airway is defibrillator charged.
free from obstruction. • D=Disability
• B=Breathing Observe patients motor response and
Patient breathing by use Glasgow Coma Scale.
observing chest movement and • E=Environment
administer oxygen. Observe what is surrounding patient
• C=Circulation ensure further harm cannot become of
Observing patients pallor and the patient.
checking for pulse.
• Call for help.
• Ensure crash team notified
by ringing 2222 emergency
number.

10. Drug Calcula<ons
Tablet formula: dose prescribed/
Dose per tablet
IV formula: amount required x drops
Per hour min
5 R’s are vital to check before administration of any drugs.
Right Patient
Right Route
Right Dose
Right Time
Right Drug
Always check notes for allergies and double check with the patient

11. Guidelines for completing the Waterlow
Pressure Ulcer Risk Assessment
Please note that this is intended to act as a guide only, and should be used in conduction and to support clinical judgment
Sex Examples score
Male Self explanatory 1
Female Self explanatory 2
Age Examples Score
Age Please determine 1-5
Appetite
Examples Score
Average Eats enough to maintain weight 0
Poor/lack of appetite Eats no more than ½ of each meal/ needs supplements 1

12. Build/ Weight for Height
Examples Score
Average Weigh patient and calculate BMI 0
Above Average Weigh patient and calculate BMI 1
Obese Weigh patient and calculate BMI 2
Below Average Weigh patient and calculate BMI 3
Continence
Examples Score
Complete/catheter fully continent and non-leaking catheter 0
Urinary incontinent incontinent of urine> 1in 12 hours 1
(inc. On newly prescribed diuretics, or UTI)
Faecally incontinent Incontinent of faeces at least once per day 2
Doubly incontinent Incontinent of urine and faeces with no control or awareness 3

13. Mobility
Examples Score
Fully Walk any distance unaided by staff, able to reposition self independently 0
Restless/fidgety Restless 1
Apathetic Walks or repositions self but needs encouragement 2
Restricted nursed in bed or chair buts needs some assistance from staff to reposition 3
Bed Bound nursed in bed, only able to make slight changes to reposition 4
(eg traction)
Chair bound nursed in a chair, only able to make slight changes to reposition 5
(eg wheelchair)
(Grade 1)
Special Risks
Examples Score
Terminal Wasting & emaciation caused by severe or chronic disease, failure 8
Cachexia/Multiple of > 1 vital organ
Organ failure
Single organ failure Failure of 1 vital organ (inc. CCF) 5
Peripheral vascular disease Diagnosed vascular, ischemic disease of the lower limbs/extremities 5
Anaemia (Hb<8) Haemoglobin <8 2
Smoking Any cigarette/tobacco 1

14. Skin Type
Examples Score
Healthy No obvious Problem 0
Tissue Paper Thin, fragile skin, reduced elasticity 1
Dry Brittle, flaking, scales 1
Oedematous Any oedema 1
Clammy Sweating, pyrexia 1
Discoloured (Grade1) Red, non-blanching, dusky 2
Broken spot (Grade 2-4) Blister, skin break or black area on any pressure point 3
Neurological deficit
Examples Score
Diabetes Diabetic, no neuropathy
Unstable diabetic, or reduced sensation in feet 5
Diabetic and no feeling in feet 6
CVA, MS, Paraplegia Able to feel pressure/sensation 4
Reduced ability to feel pressure/sensation 5
No ability to feel sensation /pressure 6
and/ or unable to communicate need to reposition due to neurological state Max 6

15. Major Surgery /Trauma
Examples Score
Orthopaedic /spinal 5
On table >2 hours Not counted after 48 hours if patient is recovering normally 5
On table >6 hours Not counted after 48 hours if patient is recovering normally 8
Medication
Examples Score
High dose steroid, Any steroid dose 7.5mg or above. Max 4
Cytotoxics, Anti-inflammatory drugs slow down the first stage of healing.

16. ECG leads Placement

17. Group
Members
Emily Asamoah
Deirdre Roche
Maeve O-carroll
Rommel Retuerma
Roxanne Burton
Okako Rumanga
Wayne Haswell