Key Concepts for an NCLEX-RN Cram Sheet Chemistry

Vital signs  Amylase: 56-90 IU/L

 Lipase: 0-110 units/L
 HR: 60-100 bpm  Total bilirubin: 0-1 mg/dL
 BP: 90/60 to 120/80 mm Hg  Albumin: 3.5-5 g/dL
 RR: 12 to 20 breaths per minute  Alfa-fetoprotein: < 10 ng/mL is normal for adults
 Temp: 36.5 to 37.2°C (97.8-99°F) > 500 could indicate liver tumors.
Lab values  Ammonia: 15-110 mg/dL
 BUN: 10-20 mg/dL
Blood Gas  Serum creatinine: 0.6-1.2 mg/dL
 Creatinine clearance: females 80-125 mL/min, males
 pH: 7.35-7.45
90-139 mL/min
 PaO2: 80-100 mm Hg
 GFR: 125 mL/min
 PaCO2: 35-45 mm Hg
 Fasting blood glucose: < 100 mg/dL
 HCO3: 22-26 mEq/L
 HbA1C: < 5.7 is normal, 5.7-6.4 prediabetic, 6.5 or
 SaO2: > 95%
higher on two separate tests means diabetes.
Lipoproteins & Triglycerides
Thyroid function
 Total: < 200 mg/dL
 Total T3: 70-205 ng/dL
 Triglycerides: < 150 mg/dL
 T4: 4-12 mcg/dL
 HDL: > 60 mg/dL
 TSH: 0.4-0.6 microunits/mL
 LDL: < 70 mg/dL
 AST: < 40 u/L Urinalysis
 ALT: < 40 u/L
 ALP: 42-128 u/L  Urine spec grav: 1.003-1.030
 Volume: 1-2 L/day
Hematology  pH: 4.5-8
 Glucose: < 130 mg/dL
 HCT female: 37-47%
 RBC: ≤ 3 RBCs
 HCT male: 42-52%
 WBCs: ≤ 2-5 WBCs/hpf
 HGB female: 12-16 g/dL
 Protein: ≤ 150 mg/dL
 HGB male: 14-18 g/dL
 Bacteria: none
 WBC: 5,000-10,000 /uL
 Ketones: none
 Platelets: 150,000-400,000 mm3
 Nitrites: neg
 PT: 11-12.5 seconds (1.5-2.5 times this if on
Warfarin) Conversions
 aPTT: 30-40 seconds (1.5-2 times this if on Heparin)
 INR: on Warfarin 2-3, not on Warfarin 0.8-1.1  1 tsp = 5 mL
 1 tbsp = 3 tsp
Cardiac markers  1 oz = 30 mL
 1 cup = 8 oz
 Troponin: < 0.01 ng/mL
 1 pint = 2 cups
 C-reactive protein: ≤ 0.8 mg/dL
 1 quart = 2 pints
 CD40 ligand: 1.51-5.35 mg/L
 1 kg = 2.2 lbs
 Creatinine kinase: 0-3 mcg/L
Therapeutic drug levels
Serum electrolytes
 Carbamazepine: 4-12 mcg/mL
 Sodium: 135-145 mEq/L
 Digoxin: 0.8-2 ng/mL
 Potassium: 3.5-5 mEq/L
 Gentamycin: 5-10 mcg/mL
 Chloride: 98-106 mEq/L
 Lithium: 0.8-1.5 mEq/L
 Calcium: 9-10.5 mEq/L
 Phenobarbital: 10-40 mcg/mL
 Magnesium: 1.3-2.1 mEq/L (therapeutic range), 4-7
 Phenytoin: 10-20 mcg/mL
mEq/L if on magnesium
 Theophylline: 10-20 mcg/dL
 Phosphorus: 3.5-4.5 mEq/L
 Valproic acid: 50-125 mcg/mL, toxic if greater than
150 mcg/mL
Pharmacology Maternity concepts

Knowing every single drug may seem like an impossible feat. FHR: 120-160 BPM
But by adding drug categories and their corresponding name
Decelerations: The trick here is to remember VEAL CHOP. Yes,
endings to your NCLEX-RN cram sheet, memorization will
VEAL CHOP. Then you need to do some practice questions
become easier, and you’ll be able to eliminate many answer
that involve interpreting strips.
choices on your pharm questions!
 Variable – Cord
 ACE inhibitors end in: -pril (lisinopril)
 Early – Head
 Beta-blockers end in: -olol (propranolol)
 Accelerations – Ok
 Abx end in: -ycin or -cillin (erythromycin, penicillin)
 Late – Placental insufficiency
 Benzodiazepines end in: -pam (diazepam)
 Phenothiazines end in: -zine (promethazine) Pregnancy drug categories
 Glucocorticoids end in: -one (prednisone)
 Antivirals end in: -vir (acyclovir)  A: No risk, human studies have been done.
 Cholesterol lowering drugs end in: -statin  B: No risk in non-human studies.
(atorvastatin)  C: Not enough research to determine risk.
 ARBs end in: -artan (valsartan)  D: Evidence of risk in humans. Avoid in pregnancy if
 H2 receptor blockers end in: -tidine (cimetidine) at all possible.
 PPIs end in: -azole (pantoprazole)  X: Contraindicated in pregnancy.
 Anticoagulants end in: -arin (heparin)
APGAR scores
Acid-base balance
Done at 1 and 5 minutes after birth. 0 points for absent, 1 for
Most nursing students agree that acid-base balance questions decreased, 2 for present. Total score from 0-3 is low, 4-6 is
are among the most challenging. Luckily, this tip will help you moderately abnormal, 7-10 is reassuring
work your way through these difficult questions:
 Appearance (color: blue or pale, acrocyanotic,
Simply remember ROME (respiratory opposite/metabolic completely pink)
equal). If the imbalance is respiratory, the pH and PaCO2 will  Pulses (heart rate: absent, <100 bmp, >100 bmp)
move in opposite directions to correct. If the imbalance is  Grimace (reflex irritability: no response, grimace, cry
metabolic, the pH and HCO3 will move in the same direction or active withdrawal)
to correct.  Activity (muscle tone: limp, some flexion, active
motion)
Here’s a breakdown of how to figure out what type of  Respiration (absent, weak cry, good cry)
alkalosis or acidosis someone is experiencing:
Glucose testing for gestational diabetes
 Respiratory acidosis: pH low, PaCO2 high, HCO3
normal GCT: Glucose challenge test (remember, everyone gets
 Respiratory alkalosis: pH high, PaCO2 low, HCO3 CHALLENGED at 24-28 weeks gestation). Patient drinks
normal glucola and 1 hour later has blood drawn. If < 140 mg/dL, it’s
 Metabolic acidosis: pH low, PaCO2 normal, HCO3 low considered normal and no GTT is necessary.
 Metabolic alkalosis: pH high, PaCO2 normal, HCO3
If ≥ 140 mg/dL, patient has to move on to a GTT. The patient
high
can eat and drink normally before the GCT.
If the body has started to compensate for any of these
GTT: Glucose tolerance test. The patient should eat and drink
situations, it will show in the opposite system. For example,
normally in days leading up to test but should fast for the 8
partially compensated respiratory acidosis will still have a low
hours before the test. They will have a blood draw for a
pH, but the HCO3 will increase to correct the acidosis.
fasting glucose level.
If fully compensated, the pH will be normal again. For
Then, the patient will drink glucola and have blood drawn at 1
partially compensated metabolic acidosis, the pH will be low,
and 2 hours after finishing the drink. Two or more of the
and the PaCO2 will lower to correct the acidosis.
following abnormal results indicates gestational diabetes:

 Fasting: > 95 mg/dL

 1 hr: > 180 mg/dL
 2 hr: > 155 mg/dL
 3 hr: > 140 mg/dL
NST: FHR accelerates at least 15 beats above baseline for 15
seconds 2 times in 20 minutes = reactive which is normal.
Otherwise non-reactive.

AVA: The umbilical cord has 2 arteries and 1 vein.

STOP: This is the procedure for maternal hypotension after

anesthesia.

 Stop Pitocin
 Turn on left side
 Oxygen
 Push IV fluids if hypovolemic

Tricks of the trade

The following tricks will help you memorize concepts that are
guaranteed to appear on your NCLEX-RN exam.

ABCs for prioritizing care:

 Airway: Is it clear?
 Breathing: Is the patient breathing?
 Circulation: What is the HR?

Rule of nines for total body surface area for burns:

 Head: 9%
 Arms: 9% each (18% total)
 Back: 18% total
 Chest & abdomen: 18% total
 Legs: 18% each (36% total)
 Genitalia: 1%

TORCH: This is for remembering some of the most common

infections that cause congenital anomalies in the newborn.

 T: Toxoplasmosis
 O: Other (syphilis, varicella-zoster, parovirus B19)
 R: Rubella
 C: Cytomegalovirus
 H: Herpes

Use the ideas and guidelines provided here as you create

your own NCLEX-RN cram sheet, but be sure to personalize it
too! Focus on the areas that give you the most difficulty.

As you review your cram sheet, you’ll build confidence, sleep

peacefully, and head into your NCLEX-RN exam rested and
prepared!