OUR LADY OF FATIMA UNIVERSITY

College of Nursing-Valenzuela City

STUDENT NAME
PROGRAM Bachelor of Science in Nursing
YEAR & SECTION
NCMB316 – Care of Clients
with Problems in Nutrition,
INSTRUCTOR
Gastrointestinal, Metabolism,
COURSE
and Endocrine, Perception
and Coordination
DATE
(SKILLS LABORATORY)

PROCEDURE : ASSESSING DEEP TENDON REFLEX

EXPECTED OUTCOME : The student should demonstrate deep tendon reflexes (DTRs) properly
ASSESSMENT TASK : Return Demonstration
Assessment Exceptional Good Average Poor SCORE
Dimension (3) (2) (1) (0)
Greeted and Performed at Performed one (1) Failed to greet
1. identified patient by least two (2) way of identifying and identify
Identifying the asking his/her name ways of patient. patient
Patient and checking his/her identifying
ID band and bed tag. patient.
Explained procedure Explained Explained Failed to explain
2. to the client clearly procedure but procedure but in procedure
Explaining the and completely with lacks details. an unclear
procedure client’s approval manner.

A. Biceps Reflex. Followed the Followed the Failed to follow

3.1. Placed the procedure with procedure with any of the steps
thumb firmly over minimum maximum of the procedure
the biceps tendon of supervision supervision
the patient, with
3.
his/her fingers
Assessing the
curling around the
Biceps Reflex
elbow.
3.2. Tapped briskly
and observed flexion
at the elbow.
B. Triceps Reflex Followed the Followed the Failed to follow
4.1. Identified the procedure with procedure with any of the steps
triceps tendon at its minimum maximum of the procedure
insertion on the supervision supervision
4. olecranon.
Assessing the 4.2 Tapped the
Triceps Reflex tendon briskly, just
above the insertion
and observed
extension of the
forearm.
C. Brachioradialis Followed the Followed the Failed to follow
Reflex procedure with procedure with any of the steps
5. 5.1. Placed the minimum maximum of the procedure
Assessing the thumb of the hand supervision supervision
Brachioradialis supporting the
Reflex patient's elbow on
the biceps tendon
5.2. Tapped the
 brachioradialis
tendon with the
other hand.
5.3. Observed three
potential reflexes
5.3.1. Brachioradialis
reflex: flexion and
supination of the
forearm.
5.3.2. Biceps reflex:
flexion of the
forearm.
5.3.3. Finger jerk:
flexion of the fingers
D. Knee Jerk Followed the Followed the Failed to follow
6.1. Allowed the procedure with procedure with any of the steps
knees swing free by minimum maximum of the procedure
the side of the bed. supervision supervision
6.
6.2. Placed one hand
Assessing the
on the quadriceps
Knee Jerk
and felt its
contraction.
6.3. Observed
Extension of the leg.
E. Ankle Jerk Followed the Followed the Failed to follow
7.1. Placed patient in procedure with procedure with any of the steps
a sitting position. minimum maximum of the procedure
7.2. Placed one hand supervision supervision
7. underneath the sole
Assessing the and slightly
Ankle Jerk dorsiflexed the foot.
7.3. Tapped on the
Achilles tendon and
observed dorsiflexion
of the foot.
Documented the Some of the Most of the Failed to
8. information about details of details of document the
Documenting the procedure procedure were procedure were procedure
the procedure properly and not documented. not documented.
completely

OVERALL SCORE: ______________

Target Raw Score: 18 out of 24. If raw score is less than 18, repeat the return demonstration.

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FACULTY SIGNATURE OVER PRINTED NAME