INSTRUCTIONS Student will indicate the date that the skill is performed in the course specified. Student should indicate if the skill
was performed in the lab (L) or if the skill was performed during direct patient contact (P). If the student has the opportunity to
perform a skill during direct patient care that has previously been noted as done in the lab, the student should update this form to
indicate performance of skill with a (P), and the revised date if during the same course. If the student performs a skill previously
learned in NUR 2103 during direct care of NUR 3104, the student should indicate this in the NUR 3104 column and not change the
NUR 2103 notes. This document should be completed electronically and be submitted to the clinical instructor at midterm
and final. In addition, the checklist should be kept up-to-date in the individual student portfolio. Skills taught in the NUR 2102 do not
require a date of completion but provide a frame of reference for the student to monitor health assessment skills. It is the sole
responsibility of the student to keep this document up to date.
PSYCOSOCIAL INTEGRITY
DOMESTIC VIOLENCE
PHYSICAL EXAMINATION HEALTH PROMOTION & MAINTENANCE
General Survey 9/15/2015 8/1/2017 Modules I-III
Vital Signs 9/15/2015 8/1/2017 Modules I-III
Skin, Hair, Nails & Wounds 9/15/2015 5/1/5027 Modules II-III
Head, Face, Neck, Eyes, Ears, Nose, Mouth & Throat 9/15/2015 8/1/2017 Modules II-III
Thorax & Lungs 9/15/2015 5/1/2017 Modules II-III
Cardiovascular 9/15/2015 8/1/2017 Modules II-III
Abdomen 9/15/2015 5/1/2017 Modules II-III
Musculoskeletal 9/15/2015 5/1/2017 Modules II-III
Neurologic 9/15/2015 3/3/2017 Modules II-III
Breast, Lymphatics & Genitourinary 9/15/2015 5/1/2017 Modules II-III
Assessment of the Pregnant & Postpartum Female 2/1/2017 5/1/2017 Modules III
Assessment of the Newborn, Infant & Child 2/1/2017 5/1/2017 Modules III
INTERPRETATION OF COMMON
REDUCTION OF RISK POTENTIAL
LABORATORY & DIAGNOSTIC TESTS
Blood Chemistries 9/15/2015 11/15/2016
Hematology 9/15/2015 11/15/2016
Culture 9/15/2015 10/10/2016
Urinalysis 9/15/2015 11/15/2016
Fecal Analysis 9/15/2015 10/10/2016
Cerebrospinal Fluid 9/15/2015 3/20/2017
Module II
Computer Tomography 9/15/2015 9/15/2015
Doppler Studies 9/15/2015 6/30/2017
Electrocardiograph 9/15/2015 11/15/2016
Endoscopy 9/15/2015 8/15/2016
Magnetic Resonance Imaging 9/15/2015 11/15/2016
Radiology 9/15/2015 11/15/2016
Skin Testing 9/15/2015 8/15/2016
Ultrasound 9/15/2015 11/15/2016
Perform Electrocardiogram 2/23/2016 8/16/2017
Initiate Telemetry Monitor 2/23/2016 8/16/2017
PSYCHOSOCIAL ADAPTATION
Diaphragmatic Breathing 10/1/2015 9/15/2016
Incentive Spirometer 10/1/2015 9/15/2016
Administer Oxygen: Nasal Cannula, Face Mask 10/1/2015 8/1/2017
Mechanical Ventilation: Maintaining, Suctioning, 2/29/2016 11/15/2016
Alarms, Complications
Pulse Oximeter 10/1/2015 8/1/2017
Peak Expiratory Flow 10/1/2015 10/1/2016
Chest Physiotherapy 10/1/2015 2/15/2017
Tracheostomy Care 2/9/2016 11/12/2016
Suctioning: Oropharyngeal, Nasopharyngeal, 2/9/2016 11/12/2016
Tracheostomy
Chest Tubes: Assisting with Insertion, Maintaining, 2/9/2016 2/23/2016
Removal
PHYSIOLOGICAL ADAPTATION
Gastric Tube Feedings: Nasogastric Tube, 10/1/2015 8/15/2016
Gastrostomy | Jejunostomy
PHYSIOLOGICAL ADAPTATION
Assessment 10/15/2015 4/20/2017
Dressing Change 10/15/2015 11/12/2016
Wound Irrigation 10/15/2015 12/2/2016
Sitz Bath 10/15/2015 3/15/2017
Applying Binders 4/5/2016 6/19/2017
Wound Vacuum 10/15/2015 11/5/2016
SAFETY | INFECTION
Sterile Field (also in Comp II) 2/1/2016 7/10/2017
Sterile Gloves (also in Comp II) 2/1/2016 7/10/2017
PSYCHOSOCIAL INTEGRITY
Palliative Care 4/5/2016 8/15/2016
Performing Post-mortem Care 4/5/2016 6/8/2017