PEDS-PACU Skillsheet

ADMISSION TO PACU
Initial Assessment
                             
Proper Positioning
                             
Vital Signs
                             
Neurological Status
                             
Airway Management
                             
Skil Color, Temperature, Turgor
                             
AGE SPECIFIC COMPETENCE
Neonates/Newborns (Birth-30 Days)
                             
Infants (30 Days - 1 Year)
                             
Toddler (1- 3 Years)
                             
Preschooler (3-5 Years)
                             
School Age Children (5-12 Years)
                             
Adolescents (12-18 Years)
                             
ANESTHESIA EQUIPMENT
Blood Warmer
                             
BP Monitor
                             
Thermia Blankets
                             
Dinamap
                             
Omeda
                             
Defibrillator
                             
SA02 Monitor
                             
Nitrogen Controls: Tanks
                             
Nitrogen Controls: Wall Units
                             
CARDIOVASCULAR
Placement and care of a patient on a cardiac monitor
                             
Cardioversion and Defibrillation
                             
Care of Patient with a Permanent or Temporary Pacemaker
                             
Care of the Patient with Intravascular Hemodynamic Monitoring Equipment: Pulmonary Artery Catheters
                             
Care of the Patient with Intravascular Hemodynamic Monitoring Equipment: Arterial Catheters
                             
Care of the Patient with Intravascular Hemodynamic Monitoring Equipment: Swan-Ganz Catheters
                             
Care of the Patient with Intravascular Hemodynamic Monitoring Equipment: Central Venous Catheters
                             
Care of the Patient with Intravascular Hemodynamic Monitoring Equipment: Subclavian Lines
                             
Care of the Patient with Intravascular Hemodynamic Monitoring Equipment: Epidural Catheters
                             
Hemodynamic Monitoring: Equipment Maintenance
                             
Hemodynamic Monitoring: Dressing Changes
                             
Hemodynamic Monitoring: Prevention of Complications
                             
Hemodynamic Monitoring: Leveling Waveform Analysis
                             
Obtain and Interpret: Cardiac Output
                             
Obtain and Interpret: PA Pressure
                             
Obtain and Interpret: PCWP/PAWP
                             
Obtain and Interpret: CVP
                             
Obtain and Interpret: LAP
                             
Identify Usual Dosage, Actions and Side Effects for: Antiarrhythmics
                             
Identify Usual Dosage, Actions and Side Effects for: Ionotropes
                             
Identify Usual Dosage, Actions and Side Effects for: Vasodilations
                             
Identify Usual Dosage, Actions and Side Effects for: Reversal Agents
                             
Identify Usual Dosage, Actions and Side Effects for: Betablockers
                             
Identify Usual Dosage, Actions and Side Effects for: Calcium Channel Blockers
                             
Identify Usual Dosage, Actions and Side Effects for: Inhalation Agents
                             
Calculate Infusion Rates in Dosages Ordered
                             
Arrhythmia Analysis
                             
Assist with the Insertion of a Temporary Pacemaker
                             
Use of Non-Invasive Temporary Pacing Equipment
                             
Identify Usual Dosage, Actions and Side Effects for: Vasopressors
                             
Identify Usual Dosage, Actions and Side Effects for: Muscle Relaxants
                             
CARE OF PATIENT WITH: CHEST TUBE
Set Up Closed Drainage System
                             
Recognize Air Leak
                             
Assess for Subcutaneous Emphysema
                             
Measure Drainage
                             
Troubleshoot Problems
                             
CARE OF PATIENT WITH: TUBES/DRAINS
Ileostomy: Jackson-Pratt
                             
T-Tube
                             
Foley Catheter: Urethral
                             
Foley Catheter: Suprapubic
                             
NG Tube
                             
Penrose Drain: Salem
                             
Davol: Colostomy
                             
Davol: Jejunostomy
                             
Foley Catheter: Cystotomy
                             
Penrose Drain: Sump
                             
CHARTING
Computer
                             
DARE
                             
APIE
                             
SOAPIE
                             
FOCUS
                             
Discharge Planning
                             
Utilization Review
                             
Chart Review/Audit
                             
EXPERIENCE
Admission to PACU
                             
Pulmonary/Abnormal Breathing
                             
O2 Administration
                             
Care of Patient with Chest Tube
                             
Cardiovascular
                             
Operate and Monitor Unit Equipment
                             
Anesthesia Equipment
                             
Physical Assessment of Body Systems
                             
Perform Suctioning
                             
Post-Operative Patient Care
                             
Care of Patient with Tubes/Drains
                             
IMPLEMENT APPROPRIATE NURSING INTERVENTION FOR ABNORMAL BREATH SOUNDS
Airway Insertion/Management
                             
Reposition Patient
                             
Pulmonary Toilet
                             
Bronchodiliations, Diuretics
                             
Suction, O2
                             
MONITOR RECOVERY PATIENT FROM..
Regional Anesthesia
                             
Local Anesthesia
                             
General Anesthesia
                             
O2 ADMINISTRATION
Face-Trach Mask
                             
Nasal Cannula
                             
T-Piece
                             
ETT Mechanical Ventilator
                             
OPERATE AND MONITOR UNIT EQUIPMENT
Pee-Wee Weighing Scale
                             
Hyper/Hypothermia Blanket
                             
Blood Warmer
                             
PACU Stretcher
                             
IV Pumps
                             
Invasive Pressure Monitors
                             
Collaborate with surgeon, anesthesiologist with regard to patient care
                             
Document interventions, outcomes, lab studies, MD notifications and follow-up care
                             
Perform Discharge Physical Assessment: Level of Consciousness
                             
Perform Discharge Physical Assessment: Pupillary Reactions
                             
Perform Discharge Physical Assessment: Motor and Sensory Function
                             
Perform Discharge Physical Assessment: Muscular Strength; Hand Grasps, Head Lift
                             
Implements Physican Orders
                             
Portable Suction Machine
                             
Transport Monitor
                             
Automatic BP Monitor
                             
Blanket Warmer/Bair Hugger
                             
Sequential Compression Device
                             
Pulse Oximeter
                             
Utilizes appropriate infection control measures
                             
Practice Universal Precautions
                             
PERFORM SUCTIONING
Oral
                             
Nasal
                             
Endotracheal
                             
Tracheal
                             
PHYSICAL ASSESSMENT OF BODY SYSTEMS
Cardiovascular
                             
Neurologic
                             
Gastrointestinal
                             
Genitourinary
                             
Respiratory
                             
Intergumentary
                             
POST OPERATIVE CARE FOR THE FOLLOWING PATIENT POPULATIONS:
Genitourinary Surgery
                             
Breast Surgery
                             
Genitourinary Surgery: Hypospadias
                             
Post-Angiogram
                             
Liver Biopsy
                             
Cardiac Surgery
                             
Gynecological Surgery
                             
Eye Surgery
                             
Major Abdominal Surgery
                             
ENT Surgery
                             
Genitourinary Surgery: Circumcision
                             
Thoracic Surgery
                             
Vascular Surgery
                             
Orthopedic Surgery
                             
Neurosurgery
                             
Tonsillectomy/P.E. Tubes
                             
PULMONARY
Auscultate Breath Sounds
                             
Recognize Abnormal Breath Sounds; Rales, Rhonchi
                             
RECOGNIZE ABNORMAL BREATHING
Assess Respiratory Rate, Rhythm, Depth and Symmetry
                             
Labored, Dyspneic
                             
Obstructed
                             
Laryngospasm
                             
Insufficient Reversal