Fundamentals of Nursing
Fundamentals of Nursing
The HSSC Staff Nurse paper uses Fundamentals as the backbone of safe bedside practice: the nursing process, vital signs, asepsis, positioning, medication administration, documentation and basic procedures. Questions are usually applied - what is the first action, which value is abnormal - rather than definitions.
Core rules
- Nursing process: Assessment → Diagnosis → Planning → Implementation → Evaluation. Assessment is always first; evaluation closes the loop.
- Adult vital signs: pulse 60–100/min, respiration 12–20/min, BP below 120/80 mmHg ideal, oral temperature 36.5–37.5 °C, SpO2 at least 95% on room air.
- Medical asepsis is clean technique (hand hygiene, gloves). Surgical asepsis means a sterile field, sterile gloves and no talking or coughing over the field.
- Six rights: right patient, drug, dose, route, time and documentation, plus the right to refuse.
- Pressure injury stages: I non-blanchable erythema; II partial-thickness loss; III full-thickness to fascia; IV to bone or tendon; unstageable if slough or eschar covers the wound.
Worked example
Order: 500 mL 0.9% NaCl over 4 hours, drop factor 20 gtt/mL. Drops/min = (volume × drop factor) ÷ time in minutes = (500 × 20) ÷ 240 = 10,000 ÷ 240 ≈ 42 gtt/min. Convert hours to minutes first; never put hours in the denominator.
Traps
- Pulse deficit is apical minus radial rate, counted simultaneously by two nurses; it is tested in atrial fibrillation.
- For a collapsed patient, the first action is airway, breathing or calling for help - not documentation.
- Normal values differ by age: infants have higher pulse and respiratory rates.
- A sterile glove touching a non-sterile surface contaminates the field; re-glove rather than wipe.