NANDA Nursing ES

NANDA Nursing Diagnoses › Scales

Nursing assessment scales with calculators

Score the most common nursing assessment scales in seconds: pick the options and get the total, the risk level and what to do next. Each scale includes its items, how to interpret the score (with sources), how to use it and a case study.

See scalesVital signsCalculators

Neuro and sedation

Glasgow Coma Scale (GCS)Score from 3 to 15Ramsay Sedation ScaleScore from 1 to 6

Newborn

APGAR scoreScore from 0 to 10Silverman-Andersen Retraction ScoreScore from 0 to 10Capurro MethodGestational age in weeks

Pressure injury risk

Braden ScaleScore from 6 to 23Norton ScaleScore from 5 to 20

Fall risk

Downton Fall Risk IndexScore from 0 to 11Morse Fall ScaleScore from 0 to 125

Pain

Pain scale (0–10)Score from 0 to 10

Vital signs

Normal vital signsNormal ranges by age, blood pressure and measurement technique

Nursing calculators

IV drip rate calculatorDrops per minute with macrodrip or microdrip tubing, and mL per hour.Parkland formula calculatorFluid resuscitation for burn patients in the first 24 hours.

Frequently asked questions

Why do nurses use assessment scales?

To measure one aspect of the patient, such as level of consciousness, fall risk or pain, in an objective and repeatable way, so you can track changes over time.

Which scale is used for pressure injury risk?

The Braden and Norton scales are the most widely used. On both, a lower score means higher risk.

Which scale is used for fall risk?

The Morse Fall Scale and the Downton Fall Risk Index. Your facility decides which one to use and its cutoff score.

Items and cutoff scores checked against the guidelines and publications cited on each scale page. Reviewed November 2, 2026.