Pediatrics Skills Checklist

My responses in this checklist represent a true reflection of my experience and comfort level. Please self-rate your comfort level in performing tasks in connection with the below checklist. Rate your level of comfort for each line item by following the below ranking system. Simply fill in the appropriate option immediately following the rating number.

* Typed Name (typing your name below serves as an electronic signature)

* Phone Number

* Email  

* Re-enter Email  

Level of Comfort/Experience

N/A=Non-applicable
1=Inexperienced in this area
2=Limited comfort/experience in this area
3=Comfortable/experienced in this area
4=Very comfortable/highly experienced in this area

CARDIOVASCULARNot ApplicableInexperiencedLimited ExperienceExperiencedHighly Experienced
Ausculation (rate, rhythm, volume)
Blood pressure/non-invasive
Heart sounds/murmurs
Interpret lab results: blood gases
Interpret lab results:Hemoglobin & hematocrit
Basic EKG interpretation
Bacterial endocarditis
Cardiac arrest
Cardiomyopathy
Congenital heart defects/disease
Congestive heart failure
Myocarditis
Pericarditis
Post cardiac cath
Post cardiac surgery
Rheumatic fever
Shock
Digoxin (Lanoxin) use
PULMONARYNot ApplicableInexperiencedLimited ExperienceExperiencedHighly Experienced
Breath sounds
Rate and work of breathing
Bulb syringe use
Nasal airway/suctioning
Oral airway/suctioning
Tracheostomy/suctioning
Apnea monitor use
Chest physiotherapy
Chest tube care
End tidal CO2
Face mask
Hood
Isolette
Nasal cannula
Tent
Trach collar
Water seal drainage system
Asthma
Bronchiolitis (RSV)
Bronchopulmonary dysplasia (BPD)
Croup
Cystic fibrosis
Epiglottitis
Pertussis
Pneumonia
Tonsillitis
Tuberculosis (TB)
Aminophylline (Theophylline) use
NEUROLOGICAL/ORTHONot ApplicableInexperiencedLimited ExperienceExperiencedHighly Experienced
Assess level of consciousness
Assist with lumbar puncture
ICP monitoring
Cast care
Battered child syndrome
Closed head trauma
Encephalitis
Febrile seizures
Meningitis
Multiple sclerosis
Near drowning
Neuromuscular disease
Clubfoot
Multiple trauma
Pinned fractures
Traction
Osteogenic sarcoma
Osteomyelitis
Corticosteroids
Dilantin (Phenytoin)
Phenobarbital
Valium (Diazepam)
GASTROINTESTINALNot ApplicableInexperiencedLimited ExperienceExperiencedHighly Experienced
Abdominal assessment
Nutritional assessment
Interpretation of serum electrolyte lab results
Gavage feedings
Central hyperalimentation
Peripheral hyperalimentation
Jejunal feeding
Gastrostomy/button
I-tubes
NG and sump tubes to suction
Penrose drains
Placement of naso/orogastric tube
Anal fistula
Cleft lip/palate
Colostomy
Diaphragmatic hernia
Failure to thrive (FTT)
Gastroenteritis/dehydration
GE reflux
Ileostomy
Intestinal parasites
Necrotizing enterocolitis (NEC)
Pyloric stenosis
Surgical abdomen
Ulcerative colitis
RENAL/GENITOURINARYNot ApplicableInexperiencedLimited ExperienceExperiencedHighly Experienced
Assess fluid balance
Interpret BUN and creatinine lab results
Interpret urinalysis
Assist with suprapubic tap
Collect urine specimen
Foley catheter care
Foley catheter insertion
Straight cath
Circumcision
Glomerulanephritis
Hemodialysis
Hemolytic uremic syndrome(HUS)
Hypospadias
Infantile polycystic disease
Kidney transplant
Nephrotic syndrome
Peritoneal dialysis
Renal failure
Urinary tract infection (UTI)
Wilm's tumor
ENDOCRINE/METABOLICNot ApplicableInexperiencedLimited ExperienceExperiencedHighly Experienced
Blood glucose testing
Insulin administration
Interpret blood glucose results
Interpret thyroid studies
Adrenal disorders
Cushing's syndrome
Juvenile diabetes
Pituitary disorders
Thyroid malfunction
HEMATOLOGY/ONCOLOGYNot ApplicableInexperiencedLimited ExperienceExperiencedHighly Experienced
Assess nutritional status
Interpret blood chemistry lab results
Interpret blood counts
Reverse isolation
Anemia
Bone marrow transplant
Depressed immune system
Disseminated intravascular coagulation (DIC)
Hemophilia
Hodgkin's disease
Infectious mononucleosis
Leukemia
Malignant tumors
Sickle cell anemia
Spleen trauma/splenectomy
Prednisone use
Chemo certification
IV THERAPYNot ApplicableInexperiencedLimited ExperienceExperiencedHighly Experienced
Administration of blood and blood products (Precautions, recognizing transfusion reactions and taking appropriate actions)
Start peripheral IV's
Maintenance of IV's
Administration of IV meds
Calculate drip rates
Insertion of heparin lock
Care/maintenance of central lines
INFECTIOUS DISEASESNot ApplicableInexperiencedLimited ExperienceExperiencedHighly Experienced
Fever management
AIDS
Cytomegalo virus (CMV)
Hepatitis
Kawasaki disease
Lyme disease
WOUND AND SKIN CARENot ApplicableInexperiencedLimited ExperienceExperiencedHighly Experienced
Decubitis ulcers
Pressure sores
Surgical incisions with drains (i.e. JP drain)
Sterile dressing changes
Traumatic wound care
Wound irrigations
OTHER NURSING RESPONSIBILITIESNot ApplicableInexperiencedLimited ExperienceExperiencedHighly Experienced
Charge nurse experience
Assess normal growth and development
Recognize signs of abuse or neglect
Immunization schedule
Calculation of pediatric medication doses
Eye/ear instillations
Knowledge of emergency drugs
Metered dose inhaler
Assessment of pain level/tolerance
Epidural anesthesia/analgesia
IV conscious sedation
Narcotic analgesia
Anorexia/bulimia
Craniofacial reconstruction
Depression
ENT surgery
Eye surgery
Ingestion of foreign body
Ingestion of poison or toxins
Suicidal threats/actions
Infant (30 days-1 year)
Toddler (1-3 years)
Pre-schooler (3-5 years)
School age (5-12 years)
Adolescents (12-18 years)