Skills Checklist – LPN Skills Checklist - LPNName First Last PhoneEmail CLINICAL AREAS*RarelySome ExperienceProficientTrainer / PreceptorN/ABurn UnitCardiac CareEmergency DepartmentIntensive Care UnitStep DownGynecologyLabor and DeliveryMedicalMother/BabyNeurologyNurseryObstetricsOROncologyOrthopedicsPediatricsPost PartumPsychiatryRehabilitationRenal/DialysisRespiratorySurgicalTelemetryDoctor’s OfficeHealth DepartmentCorrectionsHome HealthLong Term CareHospiceRespite CareOutpatient ClinicNursing HomeCORE SKILLS*RarelySome ExperienceProficientTrainer / PreceptorN/AAdmissions of a PatientTransfer of a PatientDischarge of a PatientAssist with Emergency Situations/CodesVital SignsPost Mortem CareAssist with DefibrillationAssist with CardioversionDocumentationPatient and Family EducationAssessment of AbuseRestraintsBody MechanicsAseptic TechniqueIsolation PrecautionsCARDIOVASCULAR - CARE OF PATIENT WITH:*RarelySome ExperienceProficientTrainer / PreceptorN/AAuscultation (rate, rhythm)Blood Pressure/Non-invasiveDopplerHeart Sounds/MurmursAnginaCardiac ArrestCardiomyopathyCarotid EndarterectomyCongestive Heart FailureFemoral-Popliteal BypassMyocarditisStatus Post MIPost AngioplastyPost Cardiac CathThrombophlebitisTemporary PacemakerPermanent PacemakerCardiac EnzymesBlood ChemistriesBasic Arrhythmia InterpretationLead PlacementPULMONARY - CARE OF PATIENT WITH:*RarelySome ExperienceProficientTrainer / PreceptorN/AVentilator/WeaningBreath SoundsRate and Work of BreathingArterial Blood Gases (ABG)AsthmaCOPDTracheostomyLobectomyPneumonectomyPneumoniaPulomonary EmbolismThoracotomyTuberculosisPulmonary EdemaPneumothoraxLaryngospasmEndotracheal Tube/SuctioningNasal Airway/SuctioningOropharyngeal/SuctioningSputum Specimen CollectionTracheostomy/SuctioningAssist with IntubationAssist with ThoracentesisChest Tube ManagementChest PhysiotherapyIncentive SpirometryPulse OximetryBag and MaskFace MaskNasal CannulaPortable O2 TankNEUROLOGICAL - CARE OF PATIENT WITH:*RarelySome ExperienceProficientTrainer / PreceptorN/AGlascow Coma ScaleLevel of ConsciousnessAssist with Lumbar PunctureUse of Hypo-Hyperthermia BlanketAneurysm PrecautionsBasal Skull FractureClosed Head InjuriesComa*CVATIADelerium Tremens*EncephalitisMeningitisNeuromuscular DisordersPsychiatric DisordersSeizuresOverdoseGuillain- Barre SyndromeExternalized VP ShuntsPost CraniotomySpinal Cord InjuriesORTHOPAEDICS - CARE OF PATIENT WITH:*RarelySome ExperienceProficientTrainer / PreceptorN/ACirculation checksGaitRange of MotionSkinWheelchair UseCane/Crutches/Walker UseAmputationArthroscopic SurgeryCastSplintKnee ImmobilizerOsteoporosisPinned FracturesTotal Joint ReplacementsContinuous Passive Motion DevicesCervical CollarProstheticsTraction- Bucks/SkeletalAuto TransfuserGASTROINTESTINAL - CARE OF PATIENT WITH:*RarelySome ExperienceProficientTrainer / PreceptorN/AAbdominal/ bowel soundsFluid BalancePlacement of NG tubePlacement of Flexible Feeding TubeAdministration of Tube FeedingFeeding PumpsGravity FeedingSalem Sump to SuctionCare of Gastrostomy TubeColostomy CareBowel ObstructionGI BleedingGI SurgeryHepatitisInflammatory Bowel DiseaseLiver FailureLiver TransplantParalytic IleusColostomy/IleostomyAbdominal TraumaGASTROINTESTINAL - CARE OF PATIENT WITH:RENAL/GENITOURINARY - CARE OF PATIENT WITH:*RarelySome ExperienceProficientTrainer / PreceptorN/AFluid Balance.Urinary OutputBUN &CreatinineCatheter CareSpecimen Collection- RoutineSpecimen Collection- 24 HoursSpecimen Collection- Clean CatchInsertion & Care of Straight and Foley Catheters- FemaleInsertion & Care of Straight and Foley Catheters- MaleHemodialysisNephrectomyPeritoneal DialysisRenal FailureRenal TransplantTURPIleal ConduitBladder IrrigationsUrinary Tract InfectionsGyn SurgeryRenal traumaENDOCRINE/ METABOLIC - CARE OF PATIENT WITH:*RarelySome ExperienceProficientTrainer / PreceptorN/AS/S Diabetic ComaS/S Insulin ComaBlood Glucose MonitoringPerforming Finger/Heel StickSliding Scale Insulin ProtocolsAdrenal Disorders (Addison’s)Diabetes MellitusDiabetes Insipidus (Pituitary Disorder)Diabetic KetoacidosisHyperthyroidismHypothyroidismThyroidectomyWOUND MANAGEMENT*RarelySome ExperienceProficientTrainer / PreceptorN/AAssess Skin for Impending BreakdownSurgical Wound HealingSterile Dressing ChangeWound VacWet to Dry DressingsFirst Degree BurnsSecond Degree BurnsThird Degree BurnsDecubitus UlcersSurgical Wounds with DrainsTraumatic WoundsWound Care IrrigationsMultiple Abdominal Wounds and DrainsGunshot WoundStab WoundLacerationsAbrasionsONCOLOGY - CARE OF PATIENT WITH:*RarelySome ExperienceProficientTrainer / PreceptorN/ABone Marrow TransplantInpatient ChemotherapyLeukemiaRadiation ImplantLymphomaDepressed Immune SystemRadiation TherapyFresh Oncology SurgeryINFECTIOUS DISEASE - CARE OF PATIENT WITH:*RarelySome ExperienceProficientTrainer / PreceptorN/AHIVMRSAC. DifficileVREHepatitis.InfluenzaIsolation Precautions.INTRAVENOUS THERAPY*RarelySome ExperienceProficientTrainer / PreceptorN/ASite AssessmentAdministration of Blood & Blood ProductsDrawing Blood from a Central LineIV InsertionHeplock FlushesAdministration of IV FluidAdministration of IV Piggy BackAdministration of IV Push MedicationsAccess VADCentral LinePeripheral LineAdministration TPN/LipidsPAIN MANAGEMENT*RarelySome ExperienceProficientTrainer / PreceptorN/AAssessment of Pain Level/ToleranceAdministration of Narcotic AnalgesiaPCA PumpsIV Conscious SedationEpidural AnesthesiaMISCELLANEOUS*RarelySome ExperienceProficientTrainer / PreceptorN/AComputerized ChartingAutomated Med. Dispensing SystemsSafe Needle DevicesPO MedicationsIM InjectionsSQ InjectionsZ- Track InjectionsRectal SuppositoriesNasal SpraysEar DropsEye DropsInhalersAssist with Emergency Drugs/Code CartTypes of Computerized Charting: (If applicable)Types of Automated Med. Dispensing Systems: (If applicable)PersonalAge Group Experience*RarelySome ExperienceProficientTrainer / PreceptorN/ANewborn (birth - 30 days)Infant (30 days - 1 year)Toddler (1 - 3 years)Preschooler (3 - 5 years)School Age (5 - 12 years)Adolescents (12 - 18 years)Young Adults (18 - 39 years)Middle Adults (39-64 years)Older Adults (64+ years)Do you speak any languages other than English?* No If yes, enter languages above, separated by commas.Confirmation* I attest that the information I have given is both true and, to the best of my knowledge, represents an accurate self assessment of my professional skills and/or education.SignatureDate MM slash DD slash YYYY