Breadcrumb Home Nurse Checklists Med-Surg Form Information Info Name * Last 4 digits of SSN * Contact Phone * Email * Proficiency Scale 1 = No Experience 2 = Need Training 3 = Able to perform with supervision 4 = Able to perform independently Cardiac Angina * Post Acute MI * Congestive Heart Failure * Post Cardiac Cath * Post Cardiac Surgery * Aneurysm * Carotid Endarterectomy * Post Vascular Surgery * Post Cardiac Transplant * Pulmonary Pneumonia * COPD * Tuberculosis * Pulmonary Embolism * Tracheostomy Management * CPAP/BiPAP * Interpretation of Arterial Blood Gases * Post Lung Transplant * Neurological & Psychiatric Stroke Scale Assessment * Traumatic Brain Injury * CVA * Post Craniotomy * Seizure Disorders * Spinal Cord Injuries * Mood Disorders * Substance Withdrawal * Orthopedics Circulation/Skin Checks * Continuous Passive Motion Devices * Ambulation Assistive Devices * Prosthetics * Cast Care * Pin Care * Traction * Total Joint Replacement * Amputation * Gastrointestinal Bariatrics * Feeding Tubes * GI Bleeding * Bowel Obstruction * GI Surgery * Liver Disease * Pancreatitis * Post Liver Transplant * Post Pancreas Transplant * Renal/Genitourinary Arteriovenous Fistula/Shunt * 3 Way Catheter & Bladder Irrigation * Suprapubic Catheter * Renal Failure * Peritoneal Dialysis * GU Surgery * Nephrostomy Tubes * Renal Transplant * Management Pre/Post Hemodialysis * Gyn Surgery * Endocrine Metabolic Diabetes Type I * Diabetes Type II * Blood Glucose Monitoring * IV Insulin Protocols * Management of Hypoglycemia * Indwelling Insulin Pumps * Pituitary Disorders * Oncology Chemotherapy Administration * Radiation Therapy * Medical Oncology * Surgical Oncology * Radiation Implants * Bone Marrow Transplant * Medications Antiarrhythmics * Anticoagulants (IV, oral, & injection) * Anti-Depressants * Anti-Hypertensives * Anti-Psychotics * Benzodiazepines * Emergency Medications * Epidural Analgesia * Inhaled Medications * Insulin * Narcotics/Opioid Analgesics (IV, oral, & injection) * Nitrates (Oral & Topical) * Non-Opioid Analgesics (IV, Oral, & Injection) * Oral Hypoglycemics * Patient Controlled Analgesia * Procedural Sedation Administration * Reversal Agents * Steroids (IV, Oral, Inhaled) * Automated Medication Dispensing (i.e. Pyxis, Omnicell) * IV Therapy Starting IVs * Central Line Blood Draws * Central Line/Implanted Line Care * TPN & Lipids * Blood Product Administration * Administration of Chemotherapy * Cardiac Monitoring & Emergency Response Placement of Telemetry Leads * Rhythm Interpretation * Dysrhythmia Management * Obtain 12 Lead EKG * Use of Rapid Response Teams * Professional Knowledge and Skills National Patient Safety Goals/Core Measures * Fall Risk Assessment/Prevention * Pressure Ulcer Risk Assessment/Prevention * Restraints/Use of Least Restrictive Device * Patient/Family Teaching * Age Specific/Population-Based Care * Isolation Precautions * Infection Prevention * Pain Assessment & Management * Charge Experience * Interpretation and Communication of Lab Values * Wound Care /Wound Vac * Specialty Beds * EMR Epic * Cerner * Eclipsys * McKesson * Meditech * Other Computerized System * Computerized Physician Order Entry * Bar Coding for Medication Administration * EMR Conversion *