PA_Module 09 Card

Student Name: ______________________________________

Date: _________________

Points Possible

Points Earned

Comments

Pre-Procedure Steps

Knocks

1

Washes hands

1

Identifies the client with 2 identifiers

1

Provides privacy

1

Explains procedure

1

Identifies any issues that may impact client safety or personal safety

1

General Survey

Assess level of consciousness

2

Assess skin color

2

Thorax

Inspect shape of thorax with comparison of anteroposterior to transverse diameters

5

Assess respiratory rate, rhythm, depth, presence of accessory muscle use or cough

5

Palpate thoracic expansion

5

Palpate for tactile fremitus

5

Lungs

Auscultate breath sounds 8 places on anterior thorax (stethoscope on skin)

10

Auscultate breath sounds 8 places on posterior thorax (stethoscope on skin)

10

Auscultate breath sounds 2 places each in axillary area bilaterally (stethoscope on skin)

10

Carotid Artery

Palpate carotid pulses (One at a time)

5

Auscultate each carotid artery for bruits (have client hold exhale, and hold breath)

5

Heart

Palpate anterior thorax for heave or thrill

5

Auscultate heart sounds in aortic, pulmonic, Erb’s point, tricuspid, and mitral areas (stethoscope on skin)

20

Post-Procedure Steps

Inquires if the client is comfortable

1

Student is professional and courteous with their communication

1

Ensures the client has their call light

1

Ensures client’s personal items are within reach (glasses, phone, etc.)

1

Washes hands

1

Total Points Earned

of 100 possible

Student Name: ______________________________________

Date: _________________

The above named student has:

Passed this skill evaluation

Failed this skill evaluation and must remediate. Plan for remediation:

Student signature and date indicating agreement with remediation plan: _____________________________________

Instructor signature and date indicating agreement with remediation plan: ___________________________________