Road Trip Nursing
333 1st. St. North -- Suite 200
Jacksonville Beach, FL 32250
Fax:(888) 794-5038
RN GERIATRIC SKILLS CHECKLIST
First Name:
Last Name:
Phone:
Email:
SSN (last 4 only):
Date:
Key - for each box mark:
1 - Limited or no experience
2 - Somewhat experienced but may need review
3 - Can function independently
4 - Competent to supervise
1 2 3 4
1 2 3 4
Systems
|
Care of Patient with
General Health Status
|
Aneurysm
Assessment
|
Angina
Normal Physiological Changes
|
Cardiac Arrest
Associated with Age
|
Congestive Heart Failure
Normal Psychological Changes
|
Internal Pace Maker
Associated with Age
|
Medications
Normal Sociological Changes
|
Heparin Drip
Associated with Age
|
Oral Anticoagulants
Normal Mental Changes
|
Oral and IV Antihypertensives
Associated with Age
|
Oral and Topical Nitrates
Procedures
|
Lasix
Reality Orientation
|
Digoxin
Resident Rights
|
Pulmonary
Use of Restraints
|
Assessment
Interdisciplinary Care Planning
|
Breath/Lung Sounds
Cardiovascular
|
Breathing Patterns
Assessment
|
Cough/Secretions
Heart Sounds
|
Skin/Nail Color
Pulses
|
Lab Results
Neck Vein Distention
|
Blood Gases
Peripheral Edema
|
Procedures
Lab Values
|
Airway Management
Cardiac Enzymes
|
Endotracheal Tube/Suctioning
Electrolytes
|
Tracheostomy Suctioning
Digoxin Levels
|
Assist with Intubation
Procedures
|
Chest Physiotherapy
Arrest Procedure/CPR
|
Intermittent Positive Pressure Treatment
Equipment
|
Pacemakers
|
Doppler
|
Antiemboletic Hose
|
|
1 2 3 4
1 2 3 4
Equipment
|
Care of Patient with continued
Oxygen Therapy &
|
Cancer of Brain
Medication Delivery Systems
|
DTs
Bag and Mask
|
Parkinsonism
Face Masks
|
Macular Degeneration
Inhalers
|
Neuromuscular Disease
Nasal Cannula
|
Neuropathy
Portable Oxygen Tank
|
Seizure Disorder
Ventilators
|
Spinal Cord Injury
Incentive Spirometer
|
Behaviors of:
Care of Patient with
|
Wandering
Asthma
|
Confusion
COPD
|
Hallucinations
Tracheostomy
|
Suicidal Ideations
Pneumonia
|
Anxiousness
Pulmonary Embolism
|
Agitation
Tuberculosis
|
Combativeness
Medications
|
Medications
Albuterol
|
Anticonvulsants
Theophylline
|
Antidepressants
Aminophylline
|
Anticholinergic Agents
Neurological/Sensory
|
Dopaminergic Agents
Assessment
|
Musculoskeletal/Integumentary
Level of Consciousness
|
Assessment
Neuro Check
|
Circulation Checks
Mental Status
|
Gait/Mobility
Motor Movement
|
ROM/Joint Movement
Seizure Activity
|
Strength
Procedures
|
Posture
Assist with Lumbar Puncture
|
Skin Integrity
Seizure Precautions
|
Procedures
Application of Hearing Aids
|
Crutch Walking
Prosthetic Eye Care
|
Pin Care
Care of Contact Lens
|
Cast Care
Equipment
|
Use of Assistive Devices
Hyper/Hypothermia Blanket
|
Body Mechanics
Care of Patient with
|
Transfer Techniques
Alzheimer’s/Dementias
|
Aphasia
|
Blindness
|
Cataracts
|
Coma
|
CVA
|
|
1 2 3 4
1 2 3 4
Equipment
|
Equipment
Special Beds
|
Drains
Traction
|
Tubes
Prosethics
|
N/G
Orthotic Devices
|
Care of Patient with
K-Pad
|
Bowel Obstruction
Splints/Immobilizers
|
Colostomy/Ileostomy
TENS
|
GI Bleeding
Hoyer Lift
|
Hepatitis
Support Devices
|
Inflammatory Bowel Disease
Cane
|
Liver Failure
Cervical Collar
|
Fistulas
Gait Belt
|
Pancreatitis
Sling
|
Medications/Supplements
Walker
|
Antiemetics
Wheelchair
|
Antispasmotics
Care of Patient with
|
Vitamins
Arthritis
|
Tube Feeding Solutions
Amputation
|
Renal/Genitourinary
Cast
|
Assessment
Osteoporosis
|
Fluid and Electrolyte Balance
Pinned Fractures
|
Lab Values
Rheumatic/Arthritic Disease
|
Electrolytes
Joint Replacement
|
BUN and Creatinine
Medications
|
Procedures
Analgesics
|
Nephrostomy Tube Care
Muscle Relaxants
|
Peritoneal Dialysis
Topical Agents
|
Bladder Training
NSAIDS
|
Equipment
Gastrointestinal
|
Bladder Irrigation
Assessment
|
Care of Patient with
Bowel Sounds
|
Peritoneal Dialysis
Nutritional Status/Weight
|
Renal Failure
Procedures
|
TURP
Lavage
|
Urinary Tract Infection
Guaiac Test
|
Urinary Diversion/Ileal
NG Tube Insertion
|
Conduit Nephrostomy
Ostomy Care
|
Medications
Paracentesis
|
KCl
Removal of Fecal Impaction
|
Diuretics
Enemas
|
Bowel Retraining
|
Oral Care/Care of Dentures
|
|
4
1 2 3 4
1 2 3 4
Endocrine/Metabolic
|
Care of Patient with
Assessment
|
Lumpectomy
Diabetic Coma
|
Mastectomy
Insulin Reaction
|
Endometriosis
Lab Values
|
Uterine Bleeding
Thyroid Function
|
Medications
Glucose Tolerance
|
Antifungal/Protozoan Agents
Fasting Blood Sugar
|
Hormone Replacement
Ketone Bodies
|
Hematology/Oncology
Serum Calcium
|
Assessment
Procedures
|
Skin Lesions/Tumors
Diabetic Teaching
|
Family History
Equipment
|
Cardinal Signs of Cancer
Insulin Pumps
|
Tumor Classifications
Care of Patient with
|
Lab Values
Diabetes Mellitus
|
Blood Counts
Disorders of Adrenal Gland
|
Blood Chemistry
Disorders of Pituitary Gland
|
Procedures
Hyperthyroidism
|
Patient/Family Counseling
Hypthyroidism
|
Grieving Process
Thyroidectomy
|
Altered Image
Medications
|
Patient Teaching
Steroids/Adrenocorticosteroids
|
Relaxation Techniques
Glucogon
|
Imagery
Insulins
|
Side Effects of Chemotherapy
Thyroid Replacement
|
Bone Marrow Aspiration
Oral Antihyperglycemics
|
Care of Patient with
Gynecologic
|
Anemia
Assessment
|
Immunosuppressed Conditions
External Genitalia
|
Inpatient Hospice
Obstetric History
|
Leukemias
Test Results
|
Medications
Pap Smear
|
Antineoplastic Agents
Mammogram
|
Chemotherapeutic Agents
Procedures
|
Douche
|
Breast Self-Exam
|
|
The information I have provided in this skills checklist is true and accurate to the best of my knowledge. I hereby authorize PPR to release this information to client facilities of PPR in relation to consideration of my employment to those facilities.
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