NUR3065L – VITAL SIGNS CHECK-OFF

Student:
Instructor
:
Satisfactory Unsatisfactory
Date:
Attempt # 1 #2 Attempt #1 #2

Pt S U Comments
Introduction
1. *Performed hand hygiene, introduced self, ID client with 2 identifiers, & explained procedure. 2
2. Determined previous vital signs for comparison and assess for signs and symptoms of respiratory 1
distress.
3. Positioned client with forearm at heart level, feet uncrossed and quiet for 5 minutes. 1
Radial Pulse
4. Placed tips of first two or three fingers along radial or thumb side of patient’s inner wrist. 1
Lightly compress against radius, obliterate pulse initially, and then relax pressure to palpate
pulse.
5. *If pulse was regular, counted rate 30 seconds and multiplied by 2. If pulse irregular, counted 2
one full minute. If irregular, assessed apical pulse. Reading within 10 BPM of faculty reading.
Respiration
6. *Count complete respiratory cycle in 30 seconds and multiply by 2 if regular. If rhythm 2
irregular, <12, or >20; then count respiratory cycles for one minute. Reading within 3 RPM of
faculty reading.
PMI
7. Located PMI (5th ICS at MCL) 1
8. *Placed stethoscope diaphragm at PMI. Counted for one full minute. 2
Blood Pressure
9. Applied center of cuff bladder 2.5 cm above brachial artery pulsation against bare skin. Cuff was 1
at level of right atrium.
10. Placed stethoscope diaphragm completely over brachial artery, the bell should not touch the 1
cuff, tubing, or clothing
11. *Rapidly inflated cuff 30 mm Hg above previously noted estimated systolic pressure. 1
12. *Released pressure 2-3 mmHg per second noting number first sound is clearly heard (systolic 1
pressure).
13. Noted number sound disappears (diastolic pressure). 1
14. *BP results within 4 mmHg of instructor’s reading. Document and discussed results with 2
client.
Conclusion
15. Assured client’s needs were met, thanked client for their time, performed hand hygiene and 1
cleaned equipment.
Total: (Student must achieve 15 points to pass.)
 NUR3065L – VITAL SIGNS CHECK-OFF
Student:
Instructor
:
Satisfactory Unsatisfactory
Date:
Attempt # 1 #2 Attempt #1 #2

*Denotes a critical element. All critical elements must be met for student to pass