Clinical References for Nurses

Comprehensive clinical references to support evidence-based nursing practice — quick access to drug information, lab values, assessment tools, and care protocols. Verify against your facility’s current policies before acting.

Essential drug information

High-alert medications

Drug calculations

Essential formulas for safe medication administration:

• Basic dosage formula (desired ÷ available × volume)
• Weight-based dosing
• IV flow rate calculations
• Unit conversions
• Pediatric dosing

Medication safety — the rights

• Right patient, drug, dose
• Right route, time, documentation
• Drug interaction checks
• Allergy verification
• Independent double-checking protocols

Laboratory values reference

Complete blood count (CBC)

Test	Normal range	Critical values
Hemoglobin	12–16 g/dL (F); 14–18 g/dL (M)	<7 or >20 g/dL
Hematocrit	36–46% (F); 41–53% (M)	<20% or >60%
WBC count	4,500–11,000/μL	<2,000 or >30,000
Platelet count	150,000–450,000/μL	<50,000 or >1,000,000

Basic metabolic panel (BMP)

Test	Normal range	Critical values
Glucose	70–100 mg/dL	<40 or >400 mg/dL
Sodium	136–145 mEq/L	<120 or >160 mEq/L
Potassium	3.5–5.0 mEq/L	<2.5 or >6.0 mEq/L
Creatinine	0.6–1.2 mg/dL	>4.0 mg/dL

Vital signs & assessment

Normal adult vital signs

• Blood pressure: <120/80 mmHg
• Heart rate: 60–100 bpm
• Respiratory rate: 12–20 breaths/min
• Temperature: 97.8–99.1°F (36.5–37.3°C)
• Oxygen saturation: ≥95% on room air

Pain assessment scales

• 0–10 numeric scale: most common adult scale
• FACES scale: pediatric and communication barriers
• FLACC scale: non-verbal patients (Face, Legs, Activity, Cry, Consolability)
• Wong-Baker scale: ages 3 and older

Glasgow Coma Scale

• Eye opening: 1–4 points
• Verbal response: 1–5 points
• Motor response: 1–6 points
• Total score: 3–15 (15 = normal)
• Severity: severe ≤8 · moderate 9–12 · mild 13–15

Emergency protocols

Code blue (cardiac arrest)

• Begin CPR immediately
• Call for help / activate the code
• Prepare the crash cart
• Establish IV access
• Prepare for intubation
• Administer medications per ACLS

Rapid response criteria

• RR <8 or >28/min
• HR <50 or >130 bpm
• SBP <90 mmHg
• O₂ sat <90% on oxygen
• Acute change in mental status
• Staff concern about the patient

Stroke assessment (BE-FAST)

• Balance — dizziness / coordination
• Eyes — vision changes
• Face — facial droop
• Arms — arm weakness
• Speech — slurred speech
• Time — time to call 911

Cardiac markers

Marker	Normal range	Peak time
Troponin I	<0.04 ng/mL	12–24 hours
Troponin T	<0.1 ng/mL	12–24 hours
CK-MB	0–7.5 ng/mL	12–24 hours
BNP	<100 pg/mL	N/A

Lipid panel

• Total cholesterol: <200 mg/dL
• LDL: <100 mg/dL (<70 if high risk)
• HDL: >40 mg/dL (M), >50 mg/dL (F)
• Triglycerides: <150 mg/dL

Coagulation studies

Test	Normal range	Therapeutic range
PT	11–13 seconds	1.5–2.5× normal
INR	0.8–1.2	2.0–3.0 (most indications)
aPTT	25–35 seconds	1.5–2.5× normal
Platelets	150,000–450,000/μL	>50,000 for procedures

Liver function tests

• ALT: 7–35 U/L
• AST: 8–35 U/L
• Bilirubin (total): 0.3–1.2 mg/dL
• Albumin: 3.5–5.0 g/dL
• Alkaline phosphatase: 44–147 U/L

IV therapy guidelines

Peripheral IV gauge selection

• 14–16G: trauma, surgery, blood transfusions
• 18–20G: general adult use, medications
• 22–24G: elderly, pediatric, fragile veins

IV fluid types

• Isotonic: 0.9% NS, LR (stays in the vascular space)
• Hypotonic: 0.45% NS, D5W (moves into cells)
• Hypertonic: 3% NS, D10W (pulls fluid from cells)

Central line types

• PICC: long-term antibiotics, chemotherapy
• Subclavian / jugular: critical care, multiple lumens
• Femoral: emergency access, temporary use

Fluid & electrolyte balance

Condition	Signs / symptoms	Treatment
Hyponatremia (<136 mEq/L)	Confusion, seizures, muscle cramps	Fluid restriction, hypertonic saline
Hypernatremia (>145 mEq/L)	Thirst, dry mucous membranes, altered LOC	Hypotonic fluids, D5W
Hypokalemia (<3.5 mEq/L)	Muscle weakness, arrhythmias, paralytic ileus	PO or IV potassium replacement
Hyperkalemia (>5.0 mEq/L)	Muscle twitching, cardiac arrhythmias	Kayexalate, insulin/D50, calcium

Blood product administration

Blood type compatibility

• O−: universal donor (RBC)
• AB+: universal recipient
• Crossmatch: required for RBC transfusion
• Type & screen: identifies ABO/Rh and antibodies

Transfusion guidelines

• Verify patient ID with two nurses
• Check the blood product against the order
• Start slowly: 2 mL/min for 15 minutes
• Monitor for reactions continuously
• Complete within 4 hours of starting
• Use an 18G or larger IV catheter

Professional resources