Experience
A	No Practice
B	Less than one year
C	One - Two years
D	Two Plus Years experience

First Name       Last Name

Cardiovascular Assessment
Auscultation (rate, rhythm)		- A B C D
Blood pressure / non-invasive		- A B C D
Doppler		- A B C D
Heart Sounds / murmurs		- A B C D
Pulses / circulation checks		- A B C D
Cardiovascular Equipment and procedures
Telemetry	Basic 12 lead interpretation	- A B C D
	Basic arrhythmia interpretation	- A B C D
	Lead placement	- A B C D
Pacemaker	Permanent	- A B C D
	Temporary	- A B C D
Cardiovascular Care of patient with
Abdominal aortic bypass		- A B C D
Aneurysm		- A B C D
Angina		- A B C D
Cardiac arrest		- A B C D
Cardiomyopathy		- A B C D
Carotid endarterectomy		- A B C D
Congestive heart failure (CHF)		- A B C D
Femoral-popliteal bypass		- A B C D
Myocarditis		- A B C D
Post acute MI (24-48 hours)		- A B C D
Post angioplasty		- A B C D
Post cardiac cath		- A B C D
Post cardiac surgery		- A B C D
Thrombophlebitis		- A B C D
Cardiovascular Medications
Heparin drip		- A B C D
Oral anticoagulants		- A B C D
Oral & IVP antihypertensives		- A B C D
Oral & Topical nitrates		- A B C D
Pulmonary Assessment
Adventitious Breath sounds		- A B C D
Rate and work of breathing		- A B C D
Pulmonary Interpretation of lab results
Blood chemistry		- A B C D
Blood gases		- A B C D
Pulmonary Equipment and procedures
Airway management devices / suctioning	Endotracheal tube / suctioning	- A B C D
	Extubation	- A B C D
	Nasal airway / suctioning	- A B C D
	Oropharyngeal / suctioning	- A B C D
	Sputum specimen collection	- A B C D
	Tracheostomy / suctioning	- A B C D
Assist with intubation		- A B C D
Assist with thoracentesis		- A B C D
Care of the patient on a ventilator		- A B C D
Care of the patient with a chest tube	Assist with set-up and insertion	- A B C D
	Measuring and emptying	- A B C D
	Removal	- A B C D
Chest physiotherapy		- A B C D
Incentive spirometry		- A B C D
Establishing an airway	Assist with intubation	- A B C D
	Oral airway insertion	- A B C D
O2 therapy & medication delivery systems	bag and mask	- A B C D
	External CPAP	- A B C D
	Face masks	- A B C D
	Nasal cannula	- A B C D
	Portable O2 tank	- A B C D
	Trach collar	- A B C D
Oximetry		- A B C D
Pulmonary Care of patient with a chest tube
Bronchoscopy		- A B C D
COPD		- A B C D
Fresh Tracheostomy		- A B C D
Lobectomy		- A B C D
Pneumonectomy		- A B C D
Pulmonary embolism		- A B C D
Thoracotomy		- A B C D
Tuberculosis		- A B C D
Neurological Assessment
Glasglow coma scale		- A B C D
Level of consciousness		- A B C D
Neurological Equipment and procedures
Assist with lumbar puncture		- A B C D
Use of hyper / hypothermia blanket		- A B C D
Neurological Care of patient with
Aneurysm precautions		- A B C D
Basal skull fracture		- A B C D
Closed head injury		- A B C D
Coma		- A B C D
CVA		- A B C D
DTs		- A B C D
Encephalitis		- A B C D
Externalized VP shunts		- A B C D
Meningitis		- A B C D
Neuromuscular disease		- A B C D
Post craniotomy		- A B C D
Seizures		- A B C D
Spinal cord injury		- A B C D
Administration of anticonvulsants		- A B C D
Orthopedics                                                                            Assessment
Circulation checks		- A B C D
Gait		- A B C D
Range of motion		- A B C D
Skin		- A B C D
Orthopedics                                                                             Equipment and procedures
Continuous passive motion devices		- A B C D
Support devices	Cane	- A B C D
	Cervical collar	- A B C D
	Gait delt	- A B C D
	Prosthetic	- A B C D
	Sling	- A B C D
	Transfer boards	- A B C D
	Walker	- A B C D
	Wheelchair	- A B C D
Traction		- A B C D
Orthopedics                                                                                       Care of patient with
Amputation		- A B C D
Arthroscopic surgery		- A B C D
Cast		- A B C D
Osteoporosis		- A B C D
Pinned fractures		- A B C D
Rheumatic / arthritic disease		- A B C D
Total hip replacement		- A B C D
Total knee replacement		- A B C D
Gastrointestinal Assessment
Abdominal / bowel sounds		- A B C D
Fluid balance		- A B C D
Nutritional		- A B C D
Interpretation of blood chemistry		- A B C D
Gastrointestinal Equipment and procedures
Administration of tube feeding		- A B C D
Administration of tube feeding	Feeding pump	- A B C D
	Gravity pump	- A B C D
	Saline lavage	- A B C D
Flexible feeding tube (Corpka, Dobhoff)		- A B C D
Management of	Gastrostomy tube	- A B C D
	Jejunostomy tube	- A B C D
	T-tube	- A B C D
Placement of masogastric tube		- A B C D
Salem sump to suction		- A B C D
Gastrointestinal Care of patient with
Bowel obstruction		- A B C D
Colostomy / ilestomy		- A B C D
GI bleeding		- A B C D
GI surgery		- A B C D
Hepatitis		- A B C D
Ileostomy		- A B C D
Inflammatory bowel disease		- A B C D
Liver failure		- A B C D
Liver transplant		- A B C D
Paralytic ileus		- A B C D
Renal / Genitourinary Assessment
A-V fistula / shunt		- A B C D
Fluid status		- A B C D
Renal / Genitourinary Interpretation of lab results
BUN & creatinine		- A B C D
Electrolytes		- A B C D
Renal / Genitourinary Equipment and procedures
Insertion & care of straight & Foley catheter	Female	- A B C D
	Male	- A B C D
Catheter care	3-way Foley	- A B C D
	Supra-pubic	- A B C D
Bladder irrigations	Continuous	- A B C D
	Intermittent	- A B C D
Specimen collection	Routine	- A B C D
	24 hour	- A B C D
Renal / Genitourinary Care of the patient with
Hemodialysis		- A B C D
Nephrectomy		- A B C D
Peritoneal dialysis		- A B C D
Renal Failure		- A B C D
Renal transplant		- A B C D
TURP		- A B C D
Urinary diversion (ileal conduit nephrostomy)		- A B C D
Urinary tract infection		- A B C D
Endocrine / Metabolic Assessment
S/S diabetic coma		- A B C D
S/S insulin reaction		- A B C D
Endocrine / Metabolic Equipment and procedures
Blood glucose monitoring		- A B C D
Blood glucose measuring device                               Type:
Performing finger stick		- A B C D
Visual blood glucose strips		- A B C D
Endocrine / Metabolic Care of patient  with
Diabetes mellitus		- A B C D
Disorders of adrenal gland (Addison's disease)		- A B C D
Disorders of pituitary gland (DI)		- A B C D
Hyperthyroidism (Grave's disease)		- A B C D
Hypothyroidism		- A B C D
Thyroidectomy -		- A B C D
Endocrine / Metabolic Medication
Insulin		- A B C D
Oral hypoglycemics		- A B C D
Steroids		- A B C D
Thyroidectomy		- A B C D
Wound Management / Surgical Assessment
Skin for impending breakdown		- A B C D
Stasis ulcers		- A B C D
Surgical wound healing		- A B C D
Wound Management / Surgical Equipment and procedures
Air fluidized, low airloss beds		- A B C D
Sterile dressing changes		- A B C D
Wound care / irrigations		- A B C D
Wound Management / Surgical Care of patients with
Burns		- A B C D
Pressure sores		- A B C D
Staged decubitus ulcers		- A B C D
Surgical wounds with drain(s)		- A B C D
Traumatic wounds		- A B C D
Oncology                                                                                 Assessment
Nutritional status		- A B C D
Pain control		- A B C D
Oncology                                                                                 Interpretation of lab results
Blood chemistry		- A B C D
Blood counts		- A B C D
Oncology                                                                                    Equipment and Procedures
Reverse isolation		- A B C D
Oncology                                                                                            Care of patient with
Bone marrow transplant		- A B C D
Fresh oncology surgery		- A B C D
Inpatient chemotherapy		- A B C D
Inpatient hospice		- A B C D
Leukemia		- A B C D
Radiation implant		- A B C D
Infectious Diseases                                                                  Interpretation of lab results
Blood count		- A B C D
Infectious Diseases                                                                                 Equipment and procedures
Fever management		- A B C D
Isolation		- A B C D
Infectious Diseases                                                                                 Care of patients with
AIDS		- A B C D
Hepatitis		- A B C D
Lyme disease		- A B C D
Phlebotomy / IV Therapy Equipment and procedures
Administration of blood / blood products	Albumin	- A B C D
	Cryoprecipitate	- A B C D
	Packed red blood cells	- A B C D
	Plasma	- A B C D
	Whole blood	- A B C D
Drawing blood from central line		- A B C D
Drawing venous blood		- A B C D
Starting IVs	Angiocath	- A B C D
	Butterfly	- A B C D
	Heparin lock	- A B C D
Phlebotomy / IV Therapy Care of patient with
Central line / catheter / dressing	Broviac	- A B C D
	Groshong	- A B C D
	Hickman	- A B C D
	Portacath	- A B C D
	Quinton	- A B C D
Peripheral line / dressing		- A B C D
Pain Management Care of patient with
Assessment of pain level / tolerance		- A B C D
Care of the patient with	Epidural anesthesia / analgesia	- A B C D
	IV conscious sedation	- A B C D
	Narcotic analgesia	- A B C D
	Patient controlled analgesia	- A B C D

The information I have provided is true and accurate to the best of my knowledge. I give authorization to Sierra Staffing, Inc. to release this information to facilities in consideration of my employment at said facility.