NRSG 2221 Skills Mastery 1 Skills Checklist

Vital Signs and Medication Administration

NOTE: Each step is worth 1 point. Bolded and italicizes steps are worth 5 points. All must be
performed and verbalized to receive credit.

Check medical record or care plan to ensure frequency of vital signs assessment.
Perform hand hygiene (put on PPE if indicated)
Introduce yourself to patient and identify patient.
Close curtain and discuss procedure with patient, assess patients ability to assist with
procedure.
Help patient into a comfortable position and be sure he has been able to rest for several
minutes prior to obtaining vital signs.
Select peripheral site to obtain peripheral pulse.
Place the first, second and third fingers over the artery and lightly compress the artery so pulses
can be felt and counted.
Using a watch with a second hand, count the pulses for 30 seconds and multiply by 2 for your
beats per minute calculation. If the rate, rhythm, or amplitude is abnormal, palpate and count
the pulse for one full minute.
Note the rate, rhythm and amplitude of the pulse.
While your fingers are still in place for pulse measurement, observe the patients respirations.
Continue using the watch to count the number of respirations for 30 seconds and multiply this
number by 2 to obtain the respirations per minute. Note the rate, depth and rhythm of the
respirations.
If the respirations are abnormal in any way, count for a full minute.
Now select the appropriate arm to obtain the patients blood pressure.
Help the patient into a position where the forearm is supported at the level of the heart.
Expose the brachial artery (remove any garments if necessary.
Palpate the brachial artery and apply the cuff with the center of the bladder over the brachial
artery so the lower edge of the cuff is about 1-2 inches above the aspect of the elbow. Line the
artery marking on the cuff with the patients brachial artery.
Wrap the cuff around the arm snuggly and smoothly and fasten it. Do not allow any clothing to
interfere with placement of the cuff.
Check to be sure the needle on the gauge is at zero and that the gauge is at eye level.
Estimate the systolic BP: Palpate the radial or brachial pulse, tighten the valve and inflate the
cuff until you can no longer palpate the radial pulse.
Note the point on the gauge where the pulse disappears. Deflate the cuff and wait 1 minute.
Obtain the BP Measurement: Place the stethoscope in your ears and place the diaphragm firmly
on the brachial artery (this can be the inner aspect of the elbow and does not have to be where
the brachial pulse is palpated).
Inflate the cuff to 30 mmHg above the point at which the estimated systolic was palpated.
 Carefully open the valve and slowly allow air to leave the cuff (allow gauge to drop about 2-3
mm per second).
Note the point at which the FIRST faint sound is auscultated. This is the systolic pressure. Read
the number to the closest 2mm Hg.
Note the point at which you hear the LAST sound; this is the diastolic pressure.
Allow any remaining air to escape quickly. If you need to retake the BP, wait 1 minute before
another attempt.
Assess the patients oral temperature: Remove the probe from the recording unit and cover
with a disposable probe cover until it snaps into place.
Place the probe beneath the patients tongue in the posterior, sublingual pocket. As the
patient to close his or her lips around the probe and hold in place until you hear a beep. Note
the temperature reading.
Remove the probe from the patients mouth and dispose of the probe cover.

Total Score: ________________ / 100 = ______________________________________