Fundamentals of Nursing
Fundamentals of Nursing is the foundation paper of the Tamil Nadu HSE Second Year Nursing (General) course. Questions test whether you can apply the nursing process, interpret vital signs, maintain asepsis and document care safely - not just recall definitions.
The nursing process
Five phases: assessment (subjective and objective data), nursing diagnosis (problem + aetiology, NANDA style), planning (measurable, time-bound goals in priority order), implementation, and evaluation.
Vital signs - adult resting values
- Temperature 36.5–37.5 °C orally
- Pulse 60–100/min, regular, good volume
- Respiration 12–20/min
- BP 120/80 mmHg; systolic ≥140 or diastolic ≥90 mmHg = hypertension
- SpO₂ 95–100% on room air
Asepsis
Medical (clean) asepsis reduces the number of organisms - hand hygiene, clean gloves, clean linen. Surgical (sterile) asepsis eliminates all organisms - sterile gloves, sterile field, sterile technique for any invasive procedure. Hand hygiene remains the single most effective measure for both.
Worked example
An order reads: 500 mL normal saline over 8 hours, drop factor 15 gtt/mL. Drops per minute = (volume × drop factor) ÷ minutes = (500 × 15) ÷ 480 = 7500 ÷ 480 = 15.6, so 16 gtt/min. Reasoning: the time must be converted to minutes before dividing, and the answer is rounded to a whole drop because a drip chamber cannot deliver a fraction of a drop.
Traps that cost marks
- Saying arteries always carry oxygenated blood - the pulmonary artery carries deoxygenated blood.
- Counting respirations after informing the patient, which alters the rate.
- Mixing medical and surgical asepsis in a single answer.
- Omitting the rights of medication administration: right patient, drug, dose, route, time and documentation.