Korean Nursing License cheat sheet

Hand hygiene is the single most effective measure for preventing healthcare-associated infection; alcohol-based rub is preferred when hands are not visibly soiled, soap and water when soiled or after C. difficile exposure.

Vital sign reference ranges for adults: oral temperature 36.4–37.4 °C, pulse 60–100/min, respiration 12–20/min, blood pressure <120/80 mmHg, oxygen saturation 95–100%.

Blood pressure cuff width should be about 40% of arm circumference and bladder length about 80%; a cuff that is too small falsely raises the reading.

Normal intake and output: average adult intake about 2,500 mL/day and urine output at least 0.5 mL/kg/hr; output under 30 mL/hr for 2 hours suggests hypovolemia or renal problem.

Body mass index = weight (kg) / height (m)²; Asian adult cutoffs classify ≥23 as overweight and ≥25 as obese.

Pain assessment tools: numeric rating scale for adults, Wong-Baker FACES or FLACC for children, PAINAD or Abbey for cognitively impaired older adults.

Aseptic technique: sterile field edges are contaminated 2.5 cm inward; items below waist level or out of direct view are considered contaminated.

Pressure injury staging: stage 1 non-blanchable erythema, stage 2 partial-thickness loss with dermis exposed, stage 3 full-thickness loss with subcutaneous fat visible, stage 4 exposed muscle, bone, or tendon.

Medication rights include right client, drug, dose, route, time, documentation, reason, and refusal; the nurse verifies identity with two identifiers before administration.

Acute myocardial infarction: MONA approach (morphine, oxygen if SpO₂ <90%, nitroglycerin, aspirin); nitrates are contraindicated within 24 hours of sildenafil use.

Heart failure with fluid overload: daily weight gain of more than 1 kg/day or 2.5 kg/week, plus crackles, jugular venous distension, and S3, signal decompensation.

Digoxin: therapeutic serum level 0.5–2.0 ng/mL; hold the dose and notify the prescriber if apical pulse is below 60/min in adults, and watch for nausea, visual halos, and bradycardia.

Chronic obstructive pulmonary disease: use low-flow oxygen titrated to SpO₂ 88–92% to avoid suppressing the hypoxic drive and worsening CO₂ retention.

Upper gastrointestinal bleeding signs include hematemesis, melena, and a rising blood urea nitrogen relative to creatinine; monitor for hypovolemic shock.

Diabetic ketoacidosis management: isotonic saline first, then insulin infusion, and add dextrose when glucose falls to about 200–250 mg/dL to prevent hypoglycemia while clearing ketones.

Acute kidney injury: oliguria is urine output below 0.5 mL/kg/hr for 6 hours; hyperkalemia and fluid overload are the most urgent threats.

Postoperative care: early ambulation and incentive spirometry reduce atelectasis and venous thromboembolism; assess bowel sounds before advancing diet after abdominal surgery.

Stroke: thrombolysis with alteplase is considered within 4.5 hours of symptom onset after excluding hemorrhage by CT; blood pressure must be below 185/110 mmHg before treatment.

Naegele's rule: estimated due date = first day of last menstrual period minus 3 months plus 7 days plus 1 year.

Normal fetal heart rate is 110–160 beats/min; late decelerations indicate uteroplacental insufficiency and require repositioning to the left side and stopping oxytocin.

Variable decelerations indicate umbilical cord compression; respond with position change, amnioinfusion consideration, and oxygen.

First stage of labor: latent phase 0–6 cm with mild contractions, active phase 6–10 cm with stronger contractions; full dilation is 10 cm.

Postpartum hemorrhage is blood loss over 500 mL after vaginal birth or 1,000 mL after cesarean; uterine atony is the most common cause, treated with fundal massage and uterotonics.

Lochia sequence: lochia rubra for 1–3 days, serosa for 4–10 days, alba after about 10 days; foul odor or return to rubra suggests infection or retained placenta.

Preeclampsia: blood pressure ≥140/90 mmHg after 20 weeks plus proteinuria or organ dysfunction; magnesium sulfate toxicity shows loss of deep tendon reflexes and respiratory depression, reversed with calcium gluconate.

Newborn Apgar score is assessed at 1 and 5 minutes across five components: heart rate, respiratory effort, muscle tone, reflex irritability, and color; each scored 0–2.

Physiologic jaundice appears after 24 hours and peaks at 3–5 days; jaundice within the first 24 hours is always pathologic and needs immediate evaluation.

Infant weight doubles by 4–6 months and triples by 12 months; birth weight is regained by 10–14 days.

Growth milestones: head control at 3 months, rolling over at 5–6 months, sitting unsupported at 6–8 months, walking at 12 months, two-word phrases at 18–24 months.

Normal pediatric respiratory rates: newborn 30–60, infant 30–53, toddler 22–37, preschool 20–28, school-age 18–25 breaths/min.

Dehydration in children: 5% weight loss is mild, 10% moderate, 15% severe; assess fontanel, mucous membranes, tears, and capillary refill.

Pediatric maintenance fluid (Holliday-Segar): 100 mL/kg/day for the first 10 kg, 50 mL/kg/day for the next 10 kg, and 20 mL/kg/day for each kilogram above 20.

Croup presents with a barking cough and inspiratory stridor; epiglottitis presents with drooling, tripod positioning, and muffled voice and requires no throat examination.

Kawasaki disease criteria include fever ≥5 days plus conjunctivitis, oral changes, rash, cervical lymphadenopathy, and extremity changes; IV immunoglobulin and aspirin prevent coronary aneurysm.

Intussusception shows colicky abdominal pain, currant-jelly stool, and a sausage-shaped mass; air or barium enema is both diagnostic and therapeutic.

Febrile seizure precautions: place the child on the side, do not restrain or insert objects in the mouth, and time the seizure; most simple febrile seizures last under 15 minutes.

Primary prevention targets healthy people (immunization, health education); secondary prevention is early detection (screening); tertiary prevention is rehabilitation and disability limitation.

Incidence counts new cases in a period; prevalence counts all existing cases at a point or period; prevalence rises when survival lengthens without cure.

Epidemiologic triangle: agent, host, and environment; breaking any link interrupts transmission.

Crude death rate = (deaths in a year / midyear population) × 1,000; infant mortality rate = (infant deaths under age 1 / live births in the year) × 1,000.

Attack rate = (new cases among exposed / total exposed) × 100; it is used in outbreak investigations of point-source exposure.

Sensitivity = true positives / (true positives + false negatives); high sensitivity is preferred for screening tests because it minimizes missed cases.

Community assessment models include the epidemiologic approach, the community-as-partner model, and the asset-based approach; data include vital statistics, census, and windshield survey findings.

Reportable infectious disease surveillance in Korea uses the mandatory notification system through the public health center (보건소) for designated category 1–4 diseases.

Herd immunity threshold depends on the basic reproduction number: the fraction needing immunity is 1 − 1/R₀, so R₀ of 5 requires about 80% coverage.

Therapeutic communication uses open-ended questions, reflection, and silence; it avoids false reassurance, advice-giving, and why-questions.

Major depressive disorder diagnosis requires at least five symptoms for 2 weeks, including depressed mood or anhedonia, plus impairment in functioning.

Serotonin syndrome signs: agitation, hyperreflexia, clonus, tremor, diarrhea, and hyperthermia; it can occur with SSRI plus MAOI or tramadol combinations.

Neuroleptic malignant syndrome shows rigidity, fever over 38 °C, autonomic instability, and elevated creatine kinase; stop the antipsychotic and treat with dantrolene or bromocriptine.

Lithium therapeutic range is 0.6–1.2 mEq/L; toxicity shows tremor, vomiting, ataxia, and confusion, and is worsened by dehydration and NSAIDs.

Alcohol withdrawal timeline: tremor and anxiety at 6–24 hours, seizures at 12–48 hours, delirium tremens at 48–96 hours; benzodiazepines are first-line treatment.

Suicide risk factors include prior attempt, hopelessness, male sex, older age, access to lethal means, and recent loss; asking directly about suicide does not increase risk.

Anorexia nervosa shows significantly low body weight, intense fear of weight gain, and body image disturbance; refeeding syndrome can cause hypophosphatemia.

Clozapine requires regular absolute neutrophil count monitoring because of agranulocytosis risk; the threshold for interruption is commonly ANC below 1,500/µL.

Nursing process steps: assessment, diagnosis, planning, implementation, and evaluation; planning includes setting measurable, time-bound goals.

Maslow's hierarchy orders needs as physiologic, safety, love and belonging, esteem, and self-actualization; lower needs are addressed first in triage.

Management functions are planning, organizing, directing, and controlling; delegation transfers tasks but not accountability, which stays with the delegating nurse.

Leadership styles: autocratic is efficient in emergencies, democratic improves satisfaction and participation, laissez-faire is effective only with highly autonomous staff.

Nursing workload tools include patient classification systems and staffing ratios; Korea's recommended inpatient nurse-to-patient ratio varies by ward grade, with higher grades requiring fewer patients per nurse.

Quality improvement uses the PDCA cycle (plan-do-check-act) and indicators such as fall rate, pressure injury incidence, and catheter-associated infection rate.

Nursing in Korea is governed by the Medical Service Act (의료법) and the Nursing Act (간호법); licensure is issued by the Minister of Health and Welfare after passing the national examination.

Conflict resolution stages include competing, avoiding, accommodating, collaborating, and compromising; collaboration is preferred when both goals and relationships matter.

Informatics: electronic medical records require role-based access control, and audit logs must be retained to protect patient privacy.

Four ethical principles: autonomy (respect for self-determination), beneficence (do good), nonmaleficence (do no harm), and justice (fair distribution).

Informed consent requires capacity, voluntariness, disclosure of risks and benefits, and understanding; a minor or incapacitated adult needs a legal guardian.

In Korea, a patient's advance directive (연명의료결정) requires a written document, verification by two physicians, and registration; it applies to dying patients and covers CPR, ventilation, dialysis, and transfusion.

Nurses must protect confidentiality under the Medical Service Act; disclosure is permitted with patient consent, legal reporting duties, or serious public health risk.

Medical error reporting: Korea's Patient Safety Act requires reporting of patient safety incidents to the Korea Institute for Healthcare Accreditation within the statutory period.

Negligence requires duty, breach of duty, causation, and damages; documentation is the primary evidence of nursing care.

Scope of practice: only licensed nurses may perform nursing acts; delegation of nursing acts to unlicensed personnel is limited to tasks permitted by law and under supervision.

Mandatory reporting duties include suspected child abuse and elder abuse, with notification to the responsible agency; reporting in good faith is protected.

Ethical decision models include the steps of identifying the problem, gathering facts, considering alternatives, making the decision, acting, and evaluating the outcome.