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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 (P)09/16/2015 Modules I-III
Vital Signs (P)09/16/2015 Modules I-III
Skin, Hair, Nails & Wounds (P)09/16/2015 Modules II-III
Head, Face, Neck, Eyes, Ears, Nose, Mouth & Throat (P)09/16/2015 Modules II-III
Thorax & Lungs (P)09/16/2015 Modules II-III
Cardiovascular (P)09/16/2015 Modules II-III
Abdomen (P)09/16/2015 Modules II-III
Musculoskeletal (P)09/16/2015 Modules II-III
Neurologic (P)09/16/2015 Modules II-III
Breast, Lymphatics & Genitourinary (P)09/16/2015 Modules II-III
INTERPRETATION OF COMMON
REDUCTION OF RISK POTENTIAL
LABORATORY & DIAGNOSTIC TESTS
Blood Chemistries (P)09/16/2015
Hematology (P)09/16/2015
Culture (P)09/16/2015
Urinalysis (P)09/16/2015
Fecal Analysis (P)09/16/2015
Cerebrospinal Fluid (P)02/4/2016
Computer Tomography (P)09/16/2015
Doppler Studies (P)03/22/2016 Module II
Electrocardiograph (P)04/2/2016
Endoscopy (P)01/6/2016
Magnetic Resonance Imaging (P)02/14/2016
Radiology (P)09/16/2015
Skin Testing (P)09/16/2015
Ultrasound (P)06/06/2016-extern
Perform Electrocardiogram (P) 9/16/2015
Initiate Telemetry Monitor (P) 9/16/2015
PHYSIOLOGICAL ADAPTATION
Gastric Tube Feedings: Nasogastric Tube, (L) 8/26/2015
Gastrostomy | Jejunostomy
Nasogastric Tube: Insertion, Maintenance, Removal (L) 8/26/2015
Gastric and Jejunum Tube Care (P)04/16/2016
PHYSIOLOGICAL ADAPTATION
Assessment 03/12/2015 (L) (P)11/17/16
Dressing Change 03/12/2015 (L) (P)11/17/16
Wound Irrigation 03/12/2015 (L) (P)11/17/16
Sitz Bath 03/12/2015 (L) (P)06/17/2016-
Extern
Applying Binders 03/12/2015 (L) (P)11/17/16
Wound Vacuum 03/12/2015 (L) (P)11/17/16
SAFETY | INFECTION
Sterile Field (also in Comp II) 01/15/2015 (L) (P)06/16/2016-
Extern
Sterile Gloves (also in Comp II) 01/15/2015 (L) (P)06/16/2016-
Extern
PSYCHOSOCIAL INTEGRITY
Palliative Care (P)02/24/2016
Performing Post-mortem Care (L) 04/24/2016