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Fundamentals

Fundamentals of Nursing Review

Educational Use Only. This app is not intended to replace instructor guidance, institutional policies, clinical judgment, or professional medical training.

Overview

Fundamentals covers the core skills every nurse needs. NCLEX tests basic care, safety, infection control, vital signs, hygiene, mobility, and basic procedures. These concepts form the foundation of all nursing practice.

Key Concepts

  • 1

    Infection control: standard precautions for all patients; transmission-based: contact (MRSA, C-diff), droplet (flu, pertussis), airborne (TB, measles, chickenpox)

  • 2

    Hand hygiene: before/after patient contact, before aseptic tasks, after body fluid exposure, after removing gloves

  • 3

    Chain of infection: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host

  • 4

    Vital signs: temperature (36.5-37.5°C), pulse (60-100), respirations (12-20), BP (<120/80), SpO2 (95-100%)

  • 5

    Pain assessment: PQRST (Provokes, Quality, Region/Severity, Timing); 5th vital sign; reassess after intervention

  • 6

    Mobility: immobility causes complications — pressure injuries, DVT, atelectasis, constipation, urinary stasis, contractures

  • 7

    Sterile technique: maintain sterile field, sterile touches sterile only, never reach across field, monitor for breaks

Nursing Interventions

  • Perform hand hygiene before and after every patient contact; use soap and water for C-diff (alcohol gel ineffective)

  • Assess vital signs baseline and as condition warrants; report abnormalities immediately

  • Turn immobile patients every 2 hours; use pressure-relieving surfaces; assess skin every shift

  • Assess pain using appropriate scale (0-10, FACES, behavioral for nonverbal); medicate and reassess

  • Maintain sterile technique for invasive procedures; recognize and correct breaks in technique

  • Implement fall precautions: bed alarm, low bed, call light in reach, non-skid footwear, frequent rounding

  • Assess and manage tubes, lines, and drains; monitor output, patency, and site condition

Critical Red Flags

  • Systolic BP <90 or >180, or symptomatic changes from baseline

  • Heart rate <50 or >120, or irregular rhythm with symptoms

  • Respiratory rate <10 or >24, or labored breathing with accessory muscle use

  • SpO2 <90% on room air

  • Temperature >38.5°C (101.3°F) or <35°C (95°F)

  • Acute change in mental status — assess for causes (infection, hypoxia, medication, electrolytes)

Key Lab Values

Temperature: 36.5-37.5°C (97.7-99.5°F)

Pulse: 60-100 bpm

Respirations: 12-20 breaths/min

Blood pressure: <120/80 mmHg

SpO2: 95-100%

Pain: 0 on appropriate scale (5th vital sign)

Patient Teaching

  • Hand hygiene is the most effective way to prevent infection spread

  • Use call light for assistance; do not attempt to get up alone if at fall risk

  • Deep breathing and incentive spirometry every hour while awake post-surgery

  • Report pain early; untreated pain slows healing and recovery

  • Change position frequently; participate in mobility as able to prevent complications

  • Keep environment clean and clutter-free; wear non-skid footwear

Educational Use Only — Not a substitute for professional training.