Med/Surg Skills Checklist
0= No Experience
1= Limited Experience
2= One to Three Years Experience
3= Able to Function Independently
4= Expert (Able to Teach and Supervise)
* Required
Your Name
*
Last Name, First Name
Your answer
BCLS
Expiration Date
Your answer
PRECAUTIONS:
Isolation, regular
Choose
0
1
2
3
4
Isolation, reverse
Choose
0
1
2
3
4
Contact Isolation
Choose
0
1
2
3
4
Respiratory Isolation
Choose
0
1
2
3
4
Sterile Dressing Changes
Choose
0
1
2
3
4
MEDICATIONS:
Unit Dose
Choose
0
1
2
3
4
Pass Medications for 1-10 patients
Choose
0
1
2
3
4
Pass Medications for 10-20 patients
Choose
0
1
2
3
4
Pediatric Conversions
Choose
0
1
2
3
4
I. V. Additives and I.V. Piggybacks
Choose
0
1
2
3
4
IV THERAPY:
Heparin Locks
Choose
0
1
2
3
4
Initiating IV Line
Choose
0
1
2
3
4
CVP Lines and Dressing Changes
Choose
0
1
2
3
4
Infusion Pumps
Choose
0
1
2
3
4
Hanging Blood and Blood Products
Choose
0
1
2
3
4
Care of cutdown
Choose
0
1
2
3
4
Administration
Choose
0
1
2
3
4
Veni-puncture
Choose
0
1
2
3
4
Arterial blood gases (obtain sample)
Choose
0
1
2
3
4
Arterial blood gases interpretation
Choose
0
1
2
3
4
RESPIRATORY THERAPY:
Suctioning Oro-naso-pharnyx
Choose
0
1
2
3
4
Tracheostomy care
Choose
0
1
2
3
4
Oxygen Equipment (mask/cannulas)
Choose
0
1
2
3
4
Ventilators
Choose
0
1
2
3
4
Endotracheal tubes
Choose
0
1
2
3
4
Chest Tubes
Choose
0
1
2
3
4
G.I. TUBES:
Naso-Gastric
Choose
0
1
2
3
4
Miller-Abbott
Choose
0
1
2
3
4
Blakemore (Minnesota) (for bleeding varices)
Choose
0
1
2
3
4
G.U.
Catheters -- Foley Insertion (male & female)
Choose
0
1
2
3
4
3-way Foley
Choose
0
1
2
3
4
Suprapubic
Choose
0
1
2
3
4
ORTHOPEDICS:
Circo-Electric bed
Choose
0
1
2
3
4
Crutchfield traction
Choose
0
1
2
3
4
Balanced Traction
Choose
0
1
2
3
4
Cast Care
Choose
0
1
2
3
4
Neurological checks
Choose
0
1
2
3
4
ADDITIONAL NURSING SKILLS:
Arrhythmia Interpretation
Choose
0
1
2
3
4
Set up & run 12-lead EKG
Choose
0
1
2
3
4
Arrests -- Initial Resuscitation (CPR)
Choose
0
1
2
3
4
Arrests -- Administration of medications and assist with initiation
Choose
0
1
2
3
4
ONCOLOGY:
Care of Oncology Patient
Choose
0
1
2
3
4
Administration of TPN
Choose
0
1
2
3
4
Care of Hickman Catheter
Choose
0
1
2
3
4
Administration of IV Drip Chemotherapy
Choose
0
1
2
3
4
Administration of IV Push Chemotherapy
Choose
0
1
2
3
4
DIAGNOSIS OR PROBLEMS
Fresh MI
Choose
0
1
2
3
4
GI Bleed
Choose
0
1
2
3
4
Drug OD
Choose
0
1
2
3
4
Ca of Lung
Choose
0
1
2
3
4
Emphysema and Asthma
Choose
0
1
2
3
4
Renal Failure
Choose
0
1
2
3
4
Psychiatric disorders
Choose
0
1
2
3
4
Diabetes
Choose
0
1
2
3
4
Cirrhosis of Liver
Choose
0
1
2
3
4
Hepatic Encephalopathy
Choose
0
1
2
3
4
Femoral bypass (vascular) procedures
Choose
0
1
2
3
4
COPD
Choose
0
1
2
3
4
Hypothyroidism
Choose
0
1
2
3
4
Hyperthyroidism
Choose
0
1
2
3
4
Decubitus Ulcers
Choose
0
1
2
3
4
Ca with Brain Metastasis
Choose
0
1
2
3
4
Gun Shot Wounds
Choose
0
1
2
3
4
Stab Wounds
Choose
0
1
2
3
4
Impending DT's
Choose
0
1
2
3
4
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