ONCOLOGY KNOWLEDGE
CHECKLIST______________
NAME:       h. Tumor Lysis Syndrome
ID #:      
DATE:       DIRECTIONS: Please indicate your level of experience by
This Skills Checklist is for use by nurses with more than
one year experience in their discipline and specialty.
Please be accurate with your assessment.
DESCRIPTION
MEDICATIONS/IV THERAPY
1. Administer PO Medications
2. Administer Topical Medications
3. Administer IM/SQ Medications
4. Administer IV Medications
5. Needle-less Systems
6. Infusion Pumps
7. Establish Peripheral IVs
8. Discontinue Peripheral IVs
9. Pain Assessment / Management
10. Draw Blood for Lab Studies
11. Admin Blood / Blood Products
12. Central Venous Lines (CVL)
13. Hickman / Broviac Catheters
14. PCA / CADD
15. Port-A-Cath
16. Infusaid
17. Infuse-A-Port
CARE OF ONCOLOGICAL PATIENT
1. Head, Neck, Chest
2. Hematologic System
3. Gastrointestinal Tract
4. Reproductive System
5. Skin (Melanomas / Nonmelanomas)
6. Urinary Tract
7. Emergencies:
a. Cardiac Tamponade
b. Dissesminated Intravascular
Coagulation
c. Hypercalcemia
d. Organ Obstruction
e. Sepsis
f. Spinal Cord Compression
g. Superior Vena Cava Syndrome
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& SKILLS
placing a check (√) in the box. Experience level:
1 NO EXPERIENCE
2 MINIMAL EXPERIENCE-requires supervision/assistance
3 MODERATELY EXPERIENCED-requires initial review,
then performs independently
1 2 3 4 4 VERY EXPERIENCED- proficient
DESCRIPTION 1 2 3 4
9. Family / Psychosocial Needs:
a. Patient/ Family Education
b. Advance Directives
c. Acute Phase
d. Chronic Phase
e. Terminal Phase
f. Bereavement Phase
g. After Treatment (Survivorship)
CANCER THERAPY
Radiation Therapy(RT):
1. Electromagnetic (X-rays, Gamma Rays)
2. Particulate (Alpha, Beta)
3. External Beam Therapy
4. Knowledge of Early Effects of RT
5. Knowledge of Interm. Effects of RT
6. Knowledge of Late Effects of RT
Brachytherapy (Sealed Sources):
1. Interstitial Radiation Therapy
2. Intracavitary Radiation Therapy.
3. Intraluminal Radiation Therapy
Radiopharmaceutical (Unsealed Sources):
1. Tracer Dose
2. Therapeutic Dose
Surgical Intervention:
1. Curative Surgery
2. Diagnostic Surgery
3. Mechanical Device Insertion
4. Palliative Surgery
5. Prophylactic Surgery
6. Reconstructive Surgery
7. Rehabilitative Surgery
8. Bone Marrow Transplant – Allogenic
 ONCOLOGY KNOWLEDGE & SKILLS
CHECKLIST______________
9. Bone Marrow Transplant - Syngenic

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 ONCOLOGY KNOWLEDGE & SKILLS
CHECKLIST______________
NAME:       2. Dactinomycin (Actinomycin)
ID #:       DESCRIPTION 1 2 3 4
DATE:       3. Daunorubicin (DaunoXome)
4. Doxorubicin (Adriamycin)
Plant Alkaloids:
ONCOLOGY HEALTH CARE SETTINGS 1. Paclitaxel (Taxol)
1. Adult 2. Vinblastine (Velban)
2. Pediatrics 3. Vincristine (Oncovin)
3. Cancer Center Hormonal Antineoplastics:
4. Radiation Oncology 1. Leuprolide (Lupron)
5. Surgical Oncology 2. Megestrol (Megace)
6. Bone Marrow Unit 3. Tamoxifen (Nolvadex)
7. Research/ Clinical Trials 4. Testolactone (Teslac)
8. Subacute/ Skilled Nursing Staff Minimize Risk of Exposure:
9. Home Health Care 1. During Preparation
10. Hospice 2. During Administration
11. Clinic- Risk Assess / Screening / 3. During Disposal
Diagnosis CLASSIFICATION OF NEOPLASMS
12. Clinic – Surgery / Gyn 1. Staging – TNM System
13. Clinic – Medical / Hematology 2. Tissue of Origin
14. Clinic Immunology / Infectious 3. Biologic Behavior
ANTINEOPLASCTIC AGENTS 4. Degree of Cell Differentiation
Routes of Administration: 5. Anatomic Site
1. Oral / SQ / IM TREATMENT SIDE EFFECTS
2. Intravenous Recognition & Management of:
3. Intraarterial 1. Anxiety / Depression
4. Intrathecal / Intraventricular 2. Metabolic Alterations
5. Intraperitoneal (Tenckhoff Catheter) 3. Hypersensitivity
6. Intrapleural 4. Fatigue
7. Intravesicular Hematopoietic
Alkylating Agents: 1. Anemia
1. Bulsufan (Myleran) 2. Leukopenia
2. Chlorambucil (Leukeran) 3. Thrombocytopenia
3.Cisplatin (Platinol) Gastrointestinal
4. Cyclophosphamide (Cytoxan) 1. Anorexia / Dehydration
5.Mechlorethamine (Mustargen) 2. Nausea / Vomiting
Antimetabolites: 3. Constipation / Diarrhea
1. Cytarabine (Ara-C) 4. Muscositis / Ulceration
2. Fluorouracil (5-FU) 5. Hepatic Toxicity
3. Mercaptopurine (6-MP) Integumentary
4. Methotrexate 1. Alopecia
5. Leucovorin Rescue Protocol 2. Dermatitis
AntineoPlastic Antibiotics: 3. Hyperpigmentation
1. Bleomycin Genitourinary
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 ONCOLOGY KNOWLEDGE & SKILLS
CHECKLIST______________
1. Cystitis
2. Renal Toxicity

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 ONCOLOGY KNOWLEDGE & SKILLS
CHECKLIST______________
NAME:      
ID #:      
DATE:      

DESCRIPTION 1 2 3 4
TREATMENT SIDE EFFECTS (CONT)
Cardiovascular
1. Cardiac Toxicity
2. Phlebitis
3. Extravasation
Neurologic
1. Neurotoxicity
2. Ototoxicity
3. Metabolic Encephalopathy
4. Peripheral Neuropathy
Pulmonary
1. Fibrosis
2. Pneumonitis
3. Edema
Reproductive
1. Infertility
2. Changes in Libido
3. Erectile Dysfunction
NUTRITION
1. Assess Nutritional Status
2. Assess / Manage Nutritional
Impairment
3. Interpretation of Lab Values
4. Oral Feedings
5. Enteral Tube Feeding
6. Peripheral Parenteral Nutrition (PPN)
7. Central TPN
COMPUTERIZED CHARTING
1. Cerner
2. Eclipsys
3. Epic
4. McKesson
5. Meditech
6. Other:

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 ONCOLOGY KNOWLEDGE & SKILLS
CHECKLIST______________

Name:       MY EXPERIENCE IS PRIMARILY IN:

Please check the boxes below for each age group for NEUROLOGY       years
which you have expertise in providing age-appropriate PULMONARY       years
nursing care. SURGICAL       years
MEDICAL       years
A. Newborn/Neonatal (birth – 30 days) CARDIAC CARE       years
B. Infant (30 days – 1 year) TELEMETRY       years
C. Toddler (1 – 3 years)
D. Preschool (3 – 5 years) I HAVE CURRENT CERTIFICATIONS FOR:
E. School Age Children (5 – 12 years)
F. Adolescent (12 – 18 years) TYPE EXPIRATION DATE (MM/DD/YY)
G. Young Adults (18 – 39 years) ARRHYTHMIA      
H. Middle Adults (40 – 64 years) CRITICAL CARE      
I. Older Adults (64 + years) ACLS      
BLS      
EXPERIENCE WITH AGE GROUPS: TNCC      
1. Able to assess age appropriate behavior, motor skills NRP      
and physiological norms. PALS      
NALS      
A B C D E F G H I Other            
Other            
Other            
2. Able to adapt care according to normal growth and Other            
development.
The information I have provided in this knowledge and
A B C D E F G H I skills checklist it true and accurate to the best of my
knowledge.

3. Able to communicate and instruct patient according to            

their age, maturity and comprehension ability. Signature (Written/Electronic) Date
ID #:      
A B C D E F G H I
This skills checklist has been reviewed and approved by
Nicole Bloxham, RN.
4. Able to provide a safe environment according to the
specific needs of various age groups.            
Signature (Written/Electronic) Date
A B C D E F G H I ID #:      

Please return to: Northwest Nurse Staffing Company, PA

ATTN: Records Dept.
Fax: (866) 352-4338

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 ONCOLOGY KNOWLEDGE & SKILLS
CHECKLIST______________
Email: records@nns-ic.com

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