Fundamentals of Nursing
Fundamentals of nursing tests the procedures, principles and documentation habits that underpin every ward. PGIMER frames items as 'what will the nurse do first' or 'which statement shows correct understanding', so procedure sequence and asepsis matter more than definitions.
Core frameworks
- Nursing process: assessment, diagnosis, planning, implementation, evaluation. Assessment always precedes intervention; evaluation compares the outcome with the stated goal.
- Asepsis: medical asepsis reduces organisms (hand hygiene, gloves, clean technique); surgical asepsis eliminates them (sterile field, sterile gloves). Sterile touches sterile only; a sterile item below waist level or outside the field is contaminated.
- Rights of medication administration: right patient, drug, dose, route, time, documentation, reason, and the right to refuse.
- Vital signs: pain is the fifth vital sign; rectal temperature is avoided in neutropenic and cardiac patients.
Worked example
Order: 1000 mL Ringer lactate over 8 hours with a 15 drop/mL set. Drops per minute = (1000 × 15) ÷ (8 × 60) = 15000 ÷ 480 = 31 drops/min. Reasoning: convert hours to minutes first, then divide total drops by total minutes; round to the nearest whole drop because a partial drop cannot be counted.
Safety details worth memorising
- Pressure injury staging: stage 1 is non-blanchable erythema with intact skin; stage 3 involves subcutaneous tissue but not bone; unstageable means eschar obscures the base.
- Fowler position is 45–60 degrees, semi-Fowler 30–45; Sims is left lateral with one thigh flexed.
- Intake-output: record all oral, IV, tube feeds, urine, vomitus and drain losses; report urine output below 0.5 mL/kg/hour.
Traps
Confusing sterilisation with disinfection, counting the first drop of an infusion as delivered volume, and documenting a medication before it is actually given.