The 48-year-old Filipino spoke only to confirm his name, age and address during the three-minute hearing at Manchester Magistrates’ Court.
He was charged following a investigation by police at Stepping Hill, where he worked.
Chua faces is accused of three murders, one charge of causing grievous bodily harm with intent, 22 counts of attempting to cause grievous bodily harm with intent, seven charges of attempting to administer poison and one count of causing poison to be administered with intent.
The father-of-two replied “Yes Ma’am” to the clerk who told him he faces a total of 34 charges, including the murders of Tracey Arden, 44, Arnold Lancaster, 71 and Derek Weaver, 83.
The nurse was told the charges were so serious that any bail application can only be dealt with at the crown court.
Chua was remanded into custody to appear at Manchester Crown Court next Tuesday.
All the alleged offences span a six-month period between June 1 2011 and January 3 2012, when patients at the hospital were allegedly poisoned.
The alleged murders of Ms Arden, Mr Lancaster and Mr Weaver took place within a 14-day period, on July 7, 11 and 21 in 2011.
Chua was first held in January 2012, and has been on bail since then, but was re-arrested and charged on Friday.