Breadcrumb Home Nurse Checklists Telemetry 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 Acute Coronary Syndrome * Congestive Heart Failure * Post Open Heart (12-24 hours) * Carotid Endarterectomy * Post Vascular Surgery * Heart Transplant * Pacemaker - Temporary/Permanent * Pacemaker - Epicardial * Sheath Removal * Heart Sounds * Pulmonary Pneumonia * Respiratory Distress * COPD * Breath Sounds * Post Thoracic Surgery * Chest Tube Placement & Management * Trach Management * Modes of Ventilation (AC/PC/SIMV/CPAP) * Intubation/Extubation * External CPAP/BiPAP * Interpretation of Arterial Blood Gases * Neurologic & Psychiatric Stroke Scale Assessment * CVA * Brain Injury * Post Craniotomy * Spinal Cord Injury * Seizure Disorders * ETOH/Drug Withdrawal * Gastrointestinal GI Bleeding * GI Surgery * Liver Failure * Pancreatitis * Liver Transplant * Pancreas Transplant * Renal/Genitourinary Renal Failure * Renal Surgery * Renal Transplant * Arteriovenous Fistula/Shunt * Nephrostomy Tubes * Peritoneal Dialysis * Endocrine Metabolic Diabetes - Hypo/Hyperglycemic Crisis * Pituitary Disorders * IV Insulin Protocols * Indwelling Insulin Pumps * Malignant Hyperthermia * Medications Anti-Arrhythmics * Anticoagulants (IV, oral, & injection) * Anti-Hypertensives * Anti-Psychotics * Anti-Seizure Medications * Benzodiazepines * Procedural Sedation * Diuretics * Emergency Medications * Inhaled Medications * Insulin * Titrate Vasoactive Drips * Manage Vasoactive Drips - No Titration * Narcotics/Opioid Analgesics (IV, oral, & injection) * Nitrates (Oral & Topical) * Non-Opioid Analgesics (IV, Oral, & Injection) * 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 * Arterial Line Management * TPN & Lipids * Blood Product Administration * Administration of Chemotherapy * Cardiac Monitoring & Emergency Response Dysrhythmia Interpretation * Dysrhythmia Management * Obtain 12 Lead EKG * Interpret 12 Lead EKG * Cardioversion * Defibrillation * Malignant Hyperthermia * 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 * Specialty Beds * EMR Epic * Cerner * Eclipsys * McKesson * Meditech * Other Computerized System * Computerized Physician Order Entry * Bar Coding for Medication Administration *