What are normal vital signs for adults in India?

Normal adult vitals: Temperature 36.1–37.2°C (97–99°F), Pulse 60–100 bpm, Respiratory Rate 12–20 breaths/min, Blood Pressure 90/60–120/80 mmHg, SpO2 95–100%, Pain Scale 0 (no pain). These are the same standards used in Indian hospitals per NMC guidelines.

What is GCS and how is it scored?

Glasgow Coma Scale (GCS) measures consciousness level. It scores Eye Opening (1–4), Verbal Response (1–5), and Motor Response (1–6). Total score ranges from 3 (deep coma/death) to 15 (fully alert). GCS ≤8 is severe brain injury; 9–12 is moderate; 13–15 is mild.

How is fluid balance calculated in nursing?

Fluid Balance = Total Intake − Total Output. Intake includes IV fluids, oral fluids, NG feeds, and blood products. Output includes urine, vomit, nasogastric drainage, wound drainage, and stool. A positive balance means more fluid in than out; negative means more out than in. Normal daily insensible loss is about 500–800 mL.

How does an insulin sliding scale work in nursing?

An insulin sliding scale adjusts the dose of short-acting insulin based on the patient's current blood glucose reading, typically checked before meals and at bedtime. For example: blood glucose 140–179 mg/dL → 2 units; 180–239 mg/dL → 4 units; 240–299 mg/dL → 6 units; 300–350 mg/dL → 8 units; above 350 → notify doctor. Doses vary by hospital protocol and patient sensitivity.

What is APGAR score and what does each letter stand for?

APGAR stands for Appearance (skin colour), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration (breathing effort). Each domain is scored 0–2, giving a total of 0–10. Assessed at 1 minute and 5 minutes after birth. Score 7–10 is normal, 4–6 moderate depression, 0–3 severe requiring immediate resuscitation.

How do you calculate vasopressor or inotrope drip rate in nursing?

Vasopressor drip rate (mL/hr) = [Dose (mcg/kg/min) × Weight (kg) × 60] ÷ Concentration (mcg/mL). Example: Dopamine 5 mcg/kg/min for a 70 kg patient using 200 mg in 250 mL (800 mcg/mL): (5 × 70 × 60) ÷ 800 = 26.25 mL/hr. Always verify concentration and rate with a second nurse before starting any vasopressor infusion.

How is NG tube feeding rate calculated for a patient?

NG feeding rate is based on the patient's daily caloric requirement (25–30 kcal/kg/day) divided by the formula caloric density (typically 1 kcal/mL). Feed rate (mL/hr) = Total daily volume ÷ 24. Start at 20–30 mL/hr and advance by 10–20 mL/hr every 4–6 hours. Check gastric residual volume every 4–6 hours — hold feeds if residual exceeds 200–250 mL.

What FiO2 does each oxygen delivery device provide?

Approximate FiO2 by device: Nasal cannula 1L=24%, 2L=28%, 3L=32%, 4L=36%, 5L=40%, 6L=44%. Simple face mask 5–6L=35–50%. Venturi mask 24–60% (controlled). Partial rebreather mask 6–10L=40–70%. Non-rebreather mask 10–15L=70–95%. HFNC 10–60L up to 100% FiO2. FiO2 varies by patient's breathing pattern and minute ventilation.

Nursing Tools India — Vasopressor Drip, NG Feeding, O2 Therapy, Burns, Drug Dose

💊 Drug Dose Calculator

Calculate safe dose and volume to administer based on patient weight.

Prescribed Dose

mg/kg

Patient Weight

Available Concentration

mg/mL

Frequency

—

mL per dose

Enter values above to calculate

💡 Formula Used

Total Dose = Prescribed (mg/kg) × Weight (kg)
Volume = Total Dose ÷ Concentration (mg/mL)
Safety check: Double-check any dose >10 mL per administration

⚠️ Nursing Safety Rules

🔟 5 Rights: Right Drug · Right Dose · Right Route · Right Time · Right Patient

⚖️ Always weigh the patient before weight-based dosing — do not estimate

🔁 Double-check high-alert drugs (insulin, heparin, potassium) with a second nurse

📋 Document administration time and patient response within 30 minutes

🚨 For paediatric doses always recheck with a paediatric dose reference

💉 IV Drip Rate Calculator

Calculate drops per minute and mL/hour for any IV infusion set.

Total Volume

Infusion Time

hours

Drop Factor (IV Set Type)

—

drops per minute

Enter volume and time above

💡 Formula Used

Drops/min = (Volume × Drop Factor) ÷ (Time × 60)
mL/hour = Volume ÷ Time

💡 IV Rate Quick Reference

Solution	Volume	Time	Rate (15gtt)	mL/hr
Normal Saline / RL	500 mL	4 hr	31 dpm	125
Normal Saline / RL	1000 mL	8 hr	31 dpm	125
DNS / D5W	500 mL	6 hr	21 dpm	83
Blood / Packed RBCs	250 mL	4 hr	10 dpm	63
Mannitol 20%	100 mL	30 min	50 dpm	200

🩸 Fluid Balance Chart

Track 24-hour intake and output. Calculates net balance automatically.

📥 INTAKE (mL)

Source	mL
IV Fluids	mL
Oral Fluids	mL
Medications	mL
NG / PEG Feed	mL
Blood Products	mL

📤 OUTPUT (mL)

Source	mL
Urine (measured)	mL
Vomiting	mL
NG Aspirate	mL
Wound Drain	mL
Insensible Loss	mL

Net Fluid Balance

0 mL

Intake = Output (Balanced)

Total Intake

0 mL

Total Output

0 mL

Urine Output

0 mL

Urine/hr (avg)

0 mL

📏 Normal Reference Values

Urine output (adult): 0.5–1 mL/kg/hr (≥30 mL/hr minimum)
Insensible loss: 500–800 mL/day (fever adds ~100–150 mL per °C)
Daily fluid requirement (adult): 30–40 mL/kg/day

🧠 Glasgow Coma Scale (GCS)

Click to select response for each domain. Total score updates live.

👁️ Eye Opening (E)

4Spontaneously✓

3To verbal command / speech✓

2To pain / pressure✓

1None✓

🗣️ Verbal Response (V)

5Oriented / converses normally✓

4Confused / disoriented✓

3Words but no sentences✓

2Sounds but no words✓

1None✓

✋ Motor Response (M)

6Obeys commands✓

5Localises pain✓

4Withdrawal from pain✓

3Abnormal flexion (Decorticate)✓

2Abnormal extension (Decerebrate)✓

1None✓

—

Select all 3 domains

E + V + M

🚨 GCS Interpretation

13–15 Mild — minor head injury, monitor closely

9–12 Moderate — hospitalise, CT scan, neuro obs q1h

3–8 Severe — consider intubation, ICU, neurosurgery consult

GCS ≤8 = intubation threshold. GCS 3 = no response (brain death protocol).

❤️ Normal Vital Signs — Adult

Standard reference values used in Indian hospitals (NMC guidelines).

🌡️

Temperature

36.1–37.2 °C

<35 or >38.5 → alert

💓

Pulse Rate

60–100 bpm

<50 or >120 → alert

🫁

Resp. Rate

12–20 /min

<10 or >24 → alert

🩺

Blood Pressure

90/60–120/80 mmHg

SBP <90 or >160 → alert

💨

SpO₂

95–100 %

<94% → O₂ therapy

🩸

Blood Glucose

70–140 mg/dL

<70 hypoglycaemia

💧

Urine Output

0.5–1 mL/kg/hr

<30 mL/hr → alert

🧒 Paediatric Vital Signs Reference

Age-based normal ranges — paediatric values differ significantly from adults.

Age Group	HR (bpm)	RR (/min)	SBP (mmHg)	SpO₂
Newborn (0–1m)	100–160	40–60	60–90	>95%
Infant (1–12m)	100–160	30–60	70–100	>95%
Toddler (1–3y)	90–150	24–40	80–110	>95%
Pre-school (3–6y)	80–140	22–34	80–110	>95%
School (6–12y)	70–120	18–30	90–120	>95%
Adolescent (12–18y)	60–100	12–20	100–130	>95%

🩸 Pain Scale Reference (NRS 0–10)

No pain — fully comfortable

1–3

Mild — annoying but manageable, no interference with activities

4–6

Moderate — interferes with activities, analgesia usually required

7–9

Severe — dominates all thought, strong analgesia needed immediately

Worst pain imaginable — emergency analgesia, escalate immediately

📋 Common Drug Doses — Quick Reference

Standard adult doses used in Indian hospitals. Always verify with current formulary.

Drug	Class	Adult Dose	Route	Frequency

⚠️ This chart is for quick reference only. Always verify doses with your hospital formulary or a senior nurse/doctor before administering.

👶 APGAR Score Calculator

Neonatal assessment at 1 min and 5 min after birth. Click each row to score.

🎨 Appearance (Skin Colour)

2Pink all over✓

1Body pink, extremities blue (acrocyanosis)✓

0Blue/pale all over✓

💓 Pulse (Heart Rate)

2≥ 100 bpm✓

1< 100 bpm✓

0Absent✓

😣 Grimace (Reflex Irritability)

2Cries, coughs or sneezes✓

1Grimace only✓

0No response✓

💪 Activity (Muscle Tone)

2Active motion, flexed limbs✓

1Some flexion✓

0Limp / no movement✓

🫁 Respiration (Breathing Effort)

2Good cry, regular breathing✓

1Slow / irregular / weak cry✓

0Absent✓

—

Select all 5 criteria

A + P + G + A + R

📊 APGAR Interpretation

7–10Normal — routine newborn care

4–6Moderate — stimulation, O₂, reassess at 5 min

0–3Severe — immediate resuscitation (NRP protocol)

A score of 10 is uncommon — most healthy newborns score 7–9 at 1 min due to acrocyanosis.

🧒 Paediatric Dose Calculator

Weight-based doses for common paediatric drugs. Always recheck with paediatric formulary.

Child's Weight

Age Group

Enter child's weight above to see calculated doses

📏 Weight Estimation (If not available)

APLS Formula (1–10 yr): Weight (kg) = (Age + 4) × 2
Broselow tape: Colour-coded — most accurate in emergency
Neonate: Average term baby ≈ 3.0–3.5 kg

📝 SBAR Shift Handover Generator

Generate a structured SBAR handover note. Fill in the fields and copy to clipboard.

S — Situation

Patient Name / ID

Age / Gender

Admission Diagnosis

Current Concern / Reason for Handover

B — Background

Relevant History / Comorbidities

Current IV Access

Known Allergies

A — Assessment (Latest Vitals)

Temp (°C)

°C

Pulse

bpm

SpO₂

Blood Pressure

mmHg

RR (/min)

/min

Pain Score (0–10)

/10

GCS

Fluid Balance (24hr)

R — Recommendation

Pending Investigations / Results

Current IV Fluids / Medications Running

Instructions for Incoming Nurse / Actions Needed

Generated Handover Note

Fill in the fields above to generate your handover note…

💉 Insulin Sliding Scale

Enter blood glucose reading to get sliding scale dose. Select sensitivity level based on doctor's order.

Blood Glucose

mg/dL

Insulin Type

Protocol Sensitivity

—

units subcutaneous

Enter blood glucose above

Full Sliding Scale Table — Medium Protocol

Blood Glucose (mg/dL)	Low (Sensitive)	Medium (Standard)	High (Resistant)	Action
< 70	HOLD insulin — treat hypoglycaemia (15g fast carbs)			🚨 Alert doctor
70 – 139	0 units	0 units	0 units	✓ No action
140 – 179	1 unit	2 units	3 units	Administer SC
180 – 239	2 units	4 units	6 units	Administer SC
240 – 299	3 units	6 units	9 units	Administer SC
300 – 350	4 units	8 units	12 units	⚠ Notify doctor
> 350	Do NOT give — call doctor immediately			🚨 Escalate

⚠️ Insulin Safety Rules

🔁 Always check BG before meals and at bedtime (AC+HS)

👥 Insulin is a HIGH-ALERT drug — always double-check dose with second nurse

🍽️ Give rapid-acting insulin only if patient is eating — not if NBM

⏱️ Give rapid-acting insulin 15 min before meal (or immediately after in hospital)

🩺 If BG <70 or >350 — always call doctor before any insulin action

📋 Document site, dose, time, and BG result in patient chart

🩹 Wound Care & Dressing Guide

Select wound type to see recommended dressing, technique, and change frequency.

Select a wound type above to view dressing protocol

📋 Wound Assessment Checklist (document each dressing)

📍 Location & size (cm L × W × D)

🎨 Wound bed colour (red/yellow/black/mixed)

💧 Exudate (none/low/mod/high, colour, odour)

🔲 Wound edges (defined/undermined/rolled)

🌡️ Periwound skin (intact/macerated/erythema)

😣 Pain score before & after dressing change

📸 Photo documentation (per hospital policy)

📆 Date, time, nurse signature

🏥 Pressure Ulcer Grading (EPUAP)

Non-blanchable erythema — skin intact, red, does not blanch on pressure. Reposition q2h, barrier cream, pressure-relieving mattress.

Partial thickness — open wound or blister, pink/red wound bed. Hydrocolloid or foam dressing. Change q3–5 days or if soiled.

Full thickness skin loss — subcutaneous fat visible, may have undermining. Alginate + foam, daily or BD change. Refer to wound care nurse.

Full thickness tissue loss — bone/tendon/muscle exposed. Immediate surgical referral. Negative pressure wound therapy (NPWT) may be indicated.

🩺 Vasopressor & Inotrope Drip Calculator

Calculate pump rate (mL/hr) from dose (mcg/kg/min) for ICU vasoactive infusions. Includes dose-zone guide and titration table.

Select Drug

Dopamine

Catecholamine — dopaminergic (low), β1 (mid), α1 (high)

Dose Range

1–20 mcg/kg/min

Dose zones:

LOW

MED

HIGH

Prescribed Dose

mcg/kg/min

Patient Weight

Concentration

mcg/mL

Standard dilution: Dopamine 200 mg in 250 mL NS = 800 mcg/mL

—

mL / hour (IV pump rate)

Enter dose and weight above

📊 Titration Table — Dopamine @ 800 mcg/mL · 70 kg

⚠️ ICU Vasopressor Safety Rules

🔌 Always give via central venous access (peripheral only in emergency)

👥 Vasopressors are HIGH-ALERT drugs — second nurse double-check mandatory

📊 Titrate in small increments (0.5–1 mcg/kg/min) every 5–15 min

🩺 Monitor BP every 5 min when titrating, then every 15 min when stable

⏱️ Do not stop vasopressors abruptly — wean by 0.5–1 unit steps

📋 Document dose, rate, MAP target, and time at each change

🍼 NG Tube Feeding Calculator

Calculate caloric needs, feed rate, protein requirement, water flush schedule, and refeeding syndrome risk — all from patient parameters.

Patient Weight

Height

Age

years

Sex

Clinical Condition

Feed Formula

Enter patient details above to calculate feeding plan

📋 NG Tube Nursing Checklist

✅ Confirm tube position (X-ray gold standard)

✅ Check pH of aspirate (target <5.5)

✅ Elevate head of bed 30–45° during feeds

✅ Flush with 30 mL water before & after medications

✅ Check residual every 4–6 hrs (hold if >200 mL)

✅ Document intake, residual, tolerance, complications

✅ Reposition tube if aspirate pH >6 without antacid

✅ Change feed bag and giving set every 24 hrs

🫁 Oxygen Therapy Decision Tool

FiO2 by device, condition-specific SpO2 targets, flow rate selector, and escalation decision guide. Click any device to see full details.

Patient's Current SpO₂

Clinical Condition

Click a device to see full details & flow rates

🔵 Nasal Cannula (NC)

1–6 L/min · Low flow · Comfortable for long-term use

24–44%

😷 Simple Face Mask

5–10 L/min · Do not use below 5 L (CO₂ rebreathing)

35–55%

🎭 Venturi Mask

Controlled FiO2 · Best for COPD · Colour-coded ports

24–60%

🫧 Partial Rebreather Mask

6–10 L/min · Has reservoir bag (no one-way valve)

40–70%

🫁 Non-Rebreather Mask (NRM)

10–15 L/min · One-way valves · Highest non-invasive FiO2

70–95%

🌊 High Flow Nasal Cannula (HFNC)

10–60 L/min · Up to 100% FiO2 · Requires specialist setup

21–100%

💨 NIV (BiPAP / CPAP)

Non-invasive ventilation · IPAP/EPAP support · ICU/HDU

21–100%

🏥 Invasive Ventilation (ETT/Trach)

Intubation · ICU only · Full airway control

21–100%

🎯 SpO₂ Target by Condition

Condition	Target SpO₂	Rationale
General / Post-op / Sepsis	94–98%	Standard target per BTS/WHO
COPD (hypercapnic)	88–92%	Avoid suppressing hypoxic drive
Acute MI / Cardiac arrest	94–98%	Hyperoxia harmful in AMI
COVID-19 / ARDS	92–96%	Higher targets worsen ARDS outcomes
Stroke (no hypoxia)	94–98%	No O₂ if SpO₂ already normal
Preterm neonate	91–95%	Retinopathy of prematurity risk
Term neonate	94–98%	Standard neonatal target

⚠️ Signs O₂ Therapy is Failing — Escalate Urgently

🔴 SpO₂ falling despite max flow rate

🔴 RR >30/min or accessory muscle use

🔴 Cyanosis not improving

🔴 Confusion, agitation, decreased GCS

🔴 Paradoxical chest movement

🔴 Silent chest on auscultation

🔴 Exhaustion — patient unable to maintain effort

🔴 SpO₂ <88% despite NRM at 15 L/min

❓ Frequently Asked Questions

How do I calculate drug dose for a patient? ▾

Use the Drug Dose tab: enter the prescribed dose (mg/kg), patient weight (kg), and available concentration (mg/mL). The calculator gives you exact mL per dose plus a safety alert if the volume seems high. Always double-check high-alert medications with a second nurse.

How do I calculate IV drip rate in drops per minute? ▾

Formula: Drops/min = (Volume × Drop Factor) ÷ Time in minutes. Use the IV Drip Rate tab and select your set type (15 gtt/mL for standard macro drip, 60 gtt/mL for micro/paediatric). The calculator also shows mL/hour and estimated finish time.

What is a normal GCS score? ▾

A fully alert patient scores 15 (E4 V5 M6). GCS 13–15 is mild injury, 9–12 moderate, 3–8 severe. A score of 8 or below is the threshold for considering airway protection. GCS 3 means no response in any domain.

What is fluid balance and why does it matter? ▾

Fluid balance = Total Intake − Total Output over 24 hours. Positive balance (more in than out) may indicate fluid overload. Negative balance may indicate dehydration or excessive losses. Maintaining balance is critical in ICU, cardiac, and renal patients.

Is this tool safe to use for actual patient care? ▾

This tool is for quick calculation and reference only. Always verify results with your hospital formulary, senior colleague, or pharmacist before administering any medication. Clinical judgment and local protocols always take precedence.

How do you calculate burns TBSA using Rule of Nines? ▾

Rule of Nines divides the body into areas of 9%: Head 9%, each arm 9% (front 4.5% + back 4.5%), chest 9%, abdomen 9%, upper back 9%, lower back 9%, each thigh 9%, each lower leg 9%, perineum 1%. Add selected areas to get total %TBSA. Only 2nd and 3rd degree burns are counted — NOT superficial/1st degree burns.

What is the Parkland formula for burns fluid resuscitation? ▾

Parkland Formula: Total fluid in 24 hours = 4 mL × Weight (kg) × %TBSA burned. Give 50% in the first 8 hours from time of injury (not admission), and the remaining 50% over the next 16 hours. Use Lactated Ringer's solution only. Monitor urine output 0.5–1 mL/kg/hr.

How does an insulin sliding scale work? ▾

A sliding scale adjusts short-acting insulin dose based on the patient's current blood glucose, checked before meals and at bedtime. BG <70 → hold insulin and treat hypoglycaemia. BG 140–179 → 2 units (medium protocol). BG 180–239 → 4 units. BG 240–299 → 6 units. BG 300–350 → 8 units + notify doctor. BG >350 → call doctor immediately. Always use a second nurse check.

What is APGAR score and how is it assessed? ▾

APGAR stands for Appearance, Pulse, Grimace, Activity, Respiration — each scored 0–2 at 1 minute and 5 minutes after birth. Score 7–10 is normal, 4–6 is moderate depression (stimulate and give O₂), 0–3 is severe requiring immediate neonatal resuscitation (NRP protocol).

How do you calculate vasopressor drip rate in nursing? ▾

Formula: mL/hr = [Dose (mcg/kg/min) × Weight (kg) × 60] ÷ Concentration (mcg/mL). Example: Noradrenaline 0.1 mcg/kg/min for 60 kg patient using 4 mg in 50 mL (80 mcg/mL): (0.1 × 60 × 60) ÷ 80 = 4.5 mL/hr. Always administer via central line and double-check with a second nurse.

How is NG tube feeding rate calculated? ▾

Daily calories = BMR × stress factor (1.0–1.6 by condition). Feed volume = Total kcal ÷ formula density (kcal/mL). Rate (mL/hr) = Total volume ÷ 24. Always start at 20–30 mL/hr and advance by 10–20 mL/hr every 4–6 hours. Check residual every 4–6 hours and hold feeds if >200 mL.

What FiO2 does each oxygen device provide? ▾

Nasal cannula: 1L=24%, 2L=28%, 4L=36%, 6L=44%. Simple mask: 35–55%. Venturi mask: 24–60% (controlled). Partial rebreather: 40–70%. Non-rebreather mask: 70–95%. HFNC: up to 100%. Values vary by patient's breathing rate and depth. For COPD patients, target SpO₂ is 88–92% to avoid suppressing the hypoxic drive.