Road Trip Nursing
333 1st. St. North -- Suite 200
Jacksonville Beach, FL 32250
Fax:(888) 794-5038

  

TELEMETRY/CARDIAC CARE/STEPDOWN 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
System   |     Monitoring – Non-invasive  
Cardiovascular   |       12 Lead EKG Interpretation
  Assessment   |       Arrhythmia Interpretation
    Abnormal Heart Sounds |       Lead Placement: 5 ElectrodeTelemetry
    Auscultation (rate, rhythm) |       Lead Placement: I, III, V-Leads
    Doppler |       Lead Placement: Lead II and MCL
    Pulses |       Rhythm Strip Assessment
    Peripheral Edema |   Equipment  
    Neck Vein Distention |     Automatic Internal  
    Lab Values   |     Cardioverter/Defibrillator
      Cardiac Enzymes and Isoenzymes |     Pacemakers  
      Electrolytes |       External
      Coagulation Studies |       Permanent
      Digoxin Levels |       Temporary Epicardial Wires
  Procedures   |       Temporary External Pacing
    Assist with   |       Temporary Transvenous
      Arterial Line Insertion |     Intra-aortic Balloon Pump
      Central Line Insertion |     12 Lead EKG
      Open Chest Emergency |   Care of Patient with  
      Pulmonary Arterial   |     Aneurysm
      Catheter/Swan-Ganz Insertion |     Acute MI
      Transesophageal Echocardiogram |     Cardiac Arrest
    Cardioversion |     Cardiomyopathy
    Hemodynamic Monitoring – Invasive   |     Unstable Angina
      Mean Arterial (MAP) |     Cardiac Tamponade
      Central Venous (CVP) |     Femoral-Popliteal Bypass
      Femoral Artery Sheath Removal |     CHF
      Pulmonary Artery/Capillary Wedge |     PTCA
      Radial Artery |     Heart Transplant
      Cardiac Index |     Open-Heart Surgery
      Cardiac Output |     Infective Endocarditis
      SVO2 |     Multiple Organ Failure
|
 
 
  1     2     3     4     1     2     3     4
  Care of Patient with (continued)   |   Procedures  
    Pericarditis |     Airway Management/Suctioning  
    Post Stent Intracoronary Placement |       Endotracheal Suctioning
    Post-CABG |       Extubation
    Post Arthrectomy |       Tracheostomy Suctioning
    Pre/Post Cardiac Catheterization |     Assist with  
    Shock   |       Bronchoscopy
      Septic |       Chest Tube Insertion
      Hypovolemic |       Emergency Tracheostomy
      Cardiogenic |       Thoracentesis
      Neurogenic |       Intubation
      Anaphylactic |       Oral Airway Insertion
  Medications   |     Chest Physiotherapy
    Atropine |     Intervention for Respiratory Complications
    Anticoagulants |       Aspiration
    Coagulants |       Laryngospasm
    ACE Inhibitors |       Tension Pneumothorax
    Lidocaine |     Weaning Modes
    Bicarbonate |   Equipment  
    Beta Blockers |     Pleurevac or Thoraclex Drainage
    Digoxin |     Water Seal Drainage
    Dopamine |     O2 Therapy Delivery Systems  
    Epinephrine |       Ambu Bag and Mask
    Isuprel |       ET Tube
    Nipride |       Face Masks
    Nitroglycerine |       Nasal Cannula
    Calcium Channel Blockers |       Portable O2 Tank
    Thrombolytic Agents |       Trach Collar
Pulmonary   |     Ventilator Management  
  Assessment   |       External CPAP
    Breath/Lung Sounds |       High Frequency Jet Ventilation
    Breathing Patterns |       IMV
    Cough/Secretions |       PEEP
    Skin/Nail Color |       Pressure Support
    Lab Values   |       Weaning Modes
      Blood Gases |     Nebulizers
      Aminophylline Levels |
|
 
 
  1     2     3     4     1     2     3     4
  Care of Patient with   | Musculoskeletal/Integumentary  
    Acute Pneumonia |   Assessment  
    ARDS |     Circulation Checks
    COPD |     Gait/Mobility
    Fresh Tracheostomy |     Strength
    Pulmonary Edema |     Posture
    Pulmonary Embolism |     Skin Integrity
    Pneumonthorax |   Procedures  
    Inhalation Injuries |     Crutch Walking
  Medications   |     Use of Assistive Devices
    Aminophylline |     Body Mechanics
    Corticosteroids |     Burn Care
    Ventolin (Albuterol) |   Equipment  
Neurological   |     Special Beds
  Assessment   |     K-Pad
    Cranial Nerves |     Splints/Immobilizers
    Level of Consciousness |     Tens
    Reflex/Motor Reflexes |     Hoyer Lift
    Visual or Communication Deficits |     Support Devices  
  Procedures   |       Cane
    Assist with Lumbar Puncture |       Cervical Collar
    Seizure Precautions |       Gain Belt
    Spinal Precautions |       Sling
    Measuring Intracranial Pressure |       Walker
  Equipment   |       Wheelchair
    Hyper/Hypothermia Blanket |   Care of Patient with  
  Care of Patient with   |     Amputation
    Coma |     Cast
    Closed Head Injury |     Laminectomy/Cervical Fusion
    CVA |     Burns
    Delirium Tremens |     Skin Grafts
    Intracranial Tumor |   Medications  
    Spinal Cord Injury |     Analgesics
    Craniotomy |     Muscle Relaxants
    CNS Infections |     Topical Agents
  Medications   |
    Decadron |
    Solu-Medral |
    Magnesium Sulfate |
    Mannitol |
    Anti-convulsants |
    Anti-depressants |
|

 
 
  1     2     3     4     1     2     3     4
Gastrointestinal   | Renal/Genitourinary  
  Assessment   |   Assessment  
    Bowel Sounds |     Fluid and Electrolyte Status
    Nutritional Status/Weight |     A/V Fistula/Shunt Status
    Lab Values   |     Lab Values  
      Serum Ammonia |       Electrolytes
      Serum Amylase |       BUN and Creatinine
      Liver Function Tests |   Procedures  
  Procedures   |     Bladder Irrigation
    Tube Feeding |     Nephrostomy Tube Management
    Management of   |     Peritoneal Dialysis
      Jejunostomy Tube |   Care of Patient with  
      T-tube |     Acute Renal Failure
      TPN and Lipids Administration |     Chronic Renal Failure
      PPN (Peripheral Parenteral Nurtition) |     Hemodialysis
    NG Tube Insertion |     Peritoneal Dialysis
    Paracentesis |     TURP
    Enemas |     Urinary Tract Infection
    Removal of Fecal Impaction |   Medications  
  Equipment   |     KCl
    Drains |     Diuretics
    Tubes   | Endocrine/Metabolic  
      N/G |   Assessment  
      G-Tube |     Mental Status
  Care of Patient with   |     Diabetic Coma
    Bowel Obstruction |     Insulin Reaction
    Colostomy |     Lab Values  
    ERCP |       Blood Glucose
    Esophageal Bleeding |       Glucose Tolerance
    GI Surgery |       Fasting Blood Sugar
    Hepatitis |       Ketone Bodies
    Ileostomy |       Serum Calcium
    Inflammatory Bowel Disease |   Equipment  
    Liver Failure |     Insulin Pumps
  Medications/Supplements   |   Care of Patient with  
    AquaMephyton (Vitamin K) |     Diabetes Mellitus
    Anti-emetics |     Diabetic Ketoacidosis
    Anti-spasmotics |     Insulin Shock
    Tube Feeding Solutions |
    Kayexelate |
|

 
 
  1     2     3     4     1     2     3     4
  Medications   |   Procedures  
    Insulins   |     Patient/Family Counseling  
      Long-acting |       Grieving Process
      Medium-acting |       Altered Image
      Short-acting |     Patient Teaching  
    Oral Antihyperglycemics |       Relaxation Techniques
    Glucogon |       Imagery
    Thyroid Replacement |       Side Effects of Chemotherapy
    Steroids-Adrenocorticosteroids |   Care of Patient with  
Hematology/Oncology   |     Anemia
  Assessment   |     Immunosuppressed Conditions
    Tumor Classifications |     DIC
    Lab Values   |   Medications  
      Blood Count Markers |     Antineoplastic Agents
      Blood Chemistry |     Chemotherapeutic Agents
    Anticoagulant Agents |
    Anticoagulant Antidotes |
 
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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