Telemetry RN Skills Assessment Today's Date: MM slash DD slash YYYY Name* First Last Email* Phone*Respiratory, Part 1Assessment of Breath Sounds 0 1 2 3 Administer O2 (NC, Mask) 0 1 2 3 Ventilate with Ambu-bag 0 1 2 3 Assist with Intubation 0 1 2 3 Care of Intubated Patient 0 1 2 3 Suctioning 0 1 2 3 Assist with Extubation 0 1 2 3 Use of Pressure Ventilators 0 1 2 3 Use of Volume Ventilators 0 1 2 3 Weaning Patient from Ventilator 0 1 2 3 Troubleshoot Ventilator Problems 0 1 2 3 Establishing an Airway 0 1 2 3 Pulse Oximetry 0 1 2 3 Perform Arterial Puncture 0 1 2 3 Draw Blood from Arterial Line 0 1 2 3 Interpret Arterial Blood Gases 0 1 2 3 Assist with Thoracentesis 0 1 2 3 Assist with Bronchoscopy 0 1 2 3 Care of Patient With:Chest Injury 0 1 2 3 Chest Tubes 0 1 2 3 Tracheostomy 0 1 2 3 Respiratory Complications 0 1 2 3 NeurologyNeuro Assessment/ Vital Signs 0 1 2 3 Glasgow Coma Scale 0 1 2 3 Assist with Lumbar Puncture 0 1 2 3 Identify Neuro Complications 0 1 2 3 Seizure Precautions 0 1 2 3 Aneurysm Precautions 0 1 2 3 Use of Rotating Bed 0 1 2 3 Use of Stryker Frame 0 1 2 3 Epidural Medication Administration 0 1 2 3 Care of Patient With:Open/Closed Head Injury 0 1 2 3 Acute CVA 0 1 2 3 Spinal Cord Injury 0 1 2 3 Craniotomy 0 1 2 3 Increased ICP 0 1 2 3 Cerebral Aneurysm 0 1 2 3 Halo Traction/Cervical Tong 0 1 2 3 Degenerative Diseases of CNSCNS Infections 0 1 2 3 Seizures 0 1 2 3 Drug Overdose / DTs 0 1 2 3 Multiple Sclerosis 0 1 2 3 Post-Op AV-Shunt 0 1 2 3 Renal, Care of Patient With:Acute Renal Failure 0 1 2 3 Chronic Renal Failure 0 1 2 3 Hemodialysis 0 1 2 3 Peritoneal Dialysis 0 1 2 3 Renal Transplant 0 1 2 3 CardiacAssessment of Heart Sounds 0 1 2 3 Place Cardiac Monitor/Telemetry 0 1 2 3 Troubleshoot Monitor/Telemetry 0 1 2 3 Identify Lethal Dysrhythmias 0 1 2 3 Perform 12-lead EKG 0 1 2 3 Basic 12-Lead Interpretation 0 1 2 3 Assist with Code 0 1 2 3 Defibrillation/Cardioversion 0 1 2 3 Automatic External Defib (AED) 0 1 2 3 Cardiac Arrest / CPR 0 1 2 3 Care of Patient With:Angina 0 1 2 3 Acute MI 0 1 2 3 Congestive Heart Failure 0 1 2 3 Pre/post Cardiac Cath 0 1 2 3 Pre/post Cardiac Surgery 0 1 2 3 Femoral-Popliteal Bypass 0 1 2 3 Aneurysm 0 1 2 3 Permanent Pacemaker 0 1 2 3 Temporary Pacemaker 0 1 2 3 Automatic Implanted Defibrillator 0 1 2 3 Heart Transplant 0 1 2 3 Assist With Insertion and Setup:Arterial Lines 0 1 2 3 Central Venous Catheter 0 1 2 3 Placement of External Pacemaker 0 1 2 3 Obtain ABG 0 1 2 3 Obtain Mixed Venous Gases 0 1 2 3 Emergency Medication AdministrationEpinephrine 0 1 2 3 Atropine 0 1 2 3 Bicarbonate 0 1 2 3 Lidocaine 0 1 2 3 Infusion Medication AdministrationBretylium 0 1 2 3 Dopamine 0 1 2 3 Insulin 0 1 2 3 Pronestyl 0 1 2 3 Infusion TherapyInfusion Pump 0 1 2 3 Syringe Pump 0 1 2 3 Hyperalimentation Admin (Perip/Central) 0 1 2 3 Blood/Blood Products Admin. 0 1 2 3 Insert Peripheral IV/Heplock 0 1 2 3 Insert PICC/Midline Catheter 0 1 2 3 Discontinue Peripheral IV/Heplock 0 1 2 3 Discontinue PICC/Midline Catheter 0 1 2 3 Titration of drips 0 1 2 3 PCA/Epidural pumps 0 1 2 3 Access & Care of:Hickman/Broviac 0 1 2 3 Groshong 0 1 2 3 Implanted Ports 0 1 2 3 PICC/Midline 0 1 2 3 GastrointestinalAssessment of Bowel Sounds 0 1 2 3 Identification of Abnormalities 0 1 2 3 Insert / Maintain Feeding Tubes 0 1 2 3 Insert/Maintain NG tubes 0 1 2 3 Care of Patients With:GI Bleed 0 1 2 3 Acute Pancreatitis 0 1 2 3 Open Abd Wound/Incision 0 1 2 3 Abdominal Aortic Aneurysm 0 1 2 3 Other, Care of Patients With:Multiple Trauma 0 1 2 3 Burns 0 1 2 3 Oncology 0 1 2 3 Chemotherapy 0 1 2 3 AIDS 0 1 2 3 Ketoacidosis 0 1 2 3 Bone Marrow Transplant 0 1 2 3 Liver Transplant 0 1 2 3 Suicide Precautions 0 1 2 3 Hyperbaric Oxygenation 0 1 2 3 Age of Patients Cared For:Newborn (birth-30 days) 0 1 2 3 Infant (30 days - 1 year) 0 1 2 3 Toddler (1 - 3 years) 0 1 2 3 Preschooler (3 - 5 years) 0 1 2 3 School Age (5 - 12 years) 0 1 2 3 Adolescents (12 - 18 years) 0 1 2 3 Young Adults (18 - 39 years) 0 1 2 3 Middle Adults (39 - 64 years) 0 1 2 3 Older Adults (64+ years) 0 1 2 3