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
Heart sounds / murmurs		- A B C D
Pulses / circulation checks		- A B C D
Cardiovascular Interpretation of lab results
Cardiac enzymes & isoenzymes		- A B C D
Coagulation studies		- A B C D
Cardiovascular Equipment and procedures
Monitoring / telemetry	Arrhythmia interpretation	- A B C D
	Basic 12 lead interpretation	- A B C D
	Lead placement - 5 electrode tele	- A B C D
	Lead placement - I, II, V-leads	- A B C D
	Lead placement - Lead II and MCL1	- A B C D
Pacemaker	Permanent	- A B C D
	Temporary epicardial wires	- A B C D
	Temporary external pacing	- A B C D
	Temporary external pacing	- A B C D
	Temporary transvenous	- A B C D
Assist with	Arterial line insertion	- A B C D
	Central line insertion	- A B C D
Hemodynamic monitoring	A-line (radial)	- A B C D
	CVP monitoring	- A B C D
	Femoral artery sheath removal	- A B C D
	Swan-Ganz	- A B C D
Perform	Controlled cardioversion	- A B C D
	Emergency defibrillation	- 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
Post acute MI (24 - 48 hours)		- A B C D
Post angioplasty		- A B C D
Post arthrectomy (DCA)		- A B C D
Post CABG (24 hours)		- A B C D
Post cardiac cath		- A B C D
Post stent placement		- A B C D
Cardiovascular Medications
Atropine		- A B C D
Bretylium (Bretylol)		- A B C D
Cardizen (Diltiazem hydrochloride)		- A B C D
Digoxin (Lanoxin)		- A B C D
Dobutamine (Dobutrex)		- A B C D
Dopamine (Intropin)		- A B C D
Epinephrine (Adrenalin)		- A B C D
Heparin		- A B C D
Lidocaine (Xylociane)		- A B C D
Nipride (Nitroprusside)		- A B C D
Nitroglyserine (Tridil)		- A B C D
Oral anticoagulants		- A B C D
Oral & IVP antihypertensives		- A B C D
Oral & topical nitrates		- A B C D
Verapamil (Calan, Isoptin, Verelan)		- A B C D
Pulmonary Assessment
Breath sounds		- A B C D
Breathing patterns		- A B C D
Pulmonary Interpretation of lab results
Arterial blood gases		- A B C D
Blood chemistry		- A B C D
Pulmonary Equipment and procedures
Assist with intubation		- A B C D
Assist with thoracentesis		- A B C D
Airway management devices / suctioning	Endotracheal tube / suctioning	- A B C D
	Nasal airway / suctioning	- A B C D
	Oximetry	- A B C D
	Sputum specimen collection	- A B C D
	Tracheostomy / suctioning	- A B C D
Care of patient on ventilator	Extubation	- A B C D
	Weaning modes	- A B C D
Care of patient with chest tube	Assist with set-up & insertion	- A B C D
	Mediastinal tube removal	- A B C D
	Pleural tube removal	- A B C D
	Use of Pleurevac or Thoraclex	- A B C D
	Use of water seal drainage system	- A B C D
Chest physiotherapy		- A B C D
Establishing an airway		- A B C D
Incentive spirometry		- A B C D
O2 therapy & medication delivery systems	Ambu bag and mask	- A B C D
	ET tube	- A B C D
	External CPAP	- A B C D
	Face masks	- A B C D
	Inhalers	- A B C D
	Nasal cannula	- A B C D
	Portable O2 tank	- A B C D
	Tracheostomy / suctioning	- A B C D
	Transtracheal cannulation	- A B C D
Oral airway insertion		- A B C D
Pulmonary Care of patient with
ARDS		- A B C D
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
Pneumonia		- A B C D
Pulmonary edema		- A B C D
Pulmonary embolism		- A B C D
Status asthmaticus		- A B C D
Thoracotomy		- A B C D
Tuberculosis		- A B C D
Pulmonary Medications
Alupent (Metaproterenol sulfate)		- A B C D
Aminophylline (Theophylline)		- A B C D
Bronkosol (Isoetharine hydrochloride)		- A B C D
Corticosteroids		- A B C D
Ventolin (Albuterol)		- A B C D
Neurological Assessment
Cerebellar function		- A B C D
Cranial nerves		- A B C D
Glasglow coma scale		- A B C D
Level of consciousness		- A B C D
Pathologic reflexes		- A B C D
Neurological Equipment and procedures
Assist with lumbar puncture		- A B C D
Halo traction		- A B C D
Nerve stimulator		- A B C D
Rotation bed		- A B C D
Seizure precautions		- 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
Multiple sclerosis		- 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
Neurological Medications
Carbamazepine (Tegretol)		- A B C D
Carbidopa-Levodopa (Sinemet)		- A B C D
Clonazepam (Klonopin)		- A B C D
Decadron (Dexamethasone)		- A B C D
Dilantin (Phenytoin)		- A B C D
Lorazepam (Ativan)		- A B C D
Methylprednisolone (Solu-Medrol)		- A B C D
Phenobarbital		- A B C D
Valium (Diazepam)		- 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 Interpretation of lab results
Serum ammonia		- A B C D
Serum amylase		- A B C D
Gastrointestinal Equipment and procedures
Administration of tube feeding	Flexible feeding tube (Corpak, Dobhoff)	- A B C D
	Placement of nasogastric tube	- A B C D
Salem sump to suction		- A B C D
Saline lavage		- A B C D
Management of	Gastrostomy tube	- A B C D
	Jejunostomy tube	- A B C D
	PPN (peripheral Parenteral nutrition)	- A B C D
	TPN and lipids administration	- A B C D
	T-tube	- A B C D
Gastrointestinal Care of patient with
Bowel obstruction		- A B C D
Colostomy		- A B C D
ERCP		- A B C D
Esophageal bleeding		- 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
Pancreatitis		- A B C D
Paralytic ileus		- A B C D
Whipple procedure		- A B C D
Renal / Genitourinary Assessment
A-V fistula / shunt		- A B C D
Fluid & electrolyte balance		- A B C D
Renal / Genitourinary Interpretation of lab results
BUN & creatinine		- 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
Supra-pubic		- A B C D
Bladder irrigation	Continuous	- A B C D
	Intermittent	- A B C D
Specimen collection	Routine	- A B C D
	24 hour	- A B C D
Nephrostomy tube care		- A B C D
Manual CAPD administration		- A B C D
Peritoneal dialysis via Automatic cycler		- A B C D
Renal / Genitourinary Care of the patient with
Hemodialysis		- A B C D
Nephrectomy		- A B C D
Peritoneal dialysis via		- A B C D
Automatic cycler		- A B C D
Renal failure		- A B C D
Renal transplant		- A B C D
TURP		- A B C D
Metabolic Assessment
S/S diabetic ketoacidosis		- A B C D
S/S insulin shock		- A B C D
Metabolic Interpretation of lab results
Blood glucose		- A B C D
Thyroid studies		- A B C D
Metabolic Equipment and procedures
Blood glucose measuring device                               Type:
Insulin administration - IV drip		- A B C D
Visual blood glucose strips		- A B C D
Metabolic Care of patient  with
Cushing's syndrome		- A B C D
Diabetes insipidus		- A B C D
Diabetes mellitus		- A B C D
Diabetic ketoacidosis		- A B C D
Disorders of adrenal gland (Addison's disease)		- A B C D
Drug overdose		- A B C D
Hyperthyroidism (Grave's disease)		- A B C D
Hypothyroidism		- A B C D
Pheochromocytoma		- A B C D
Post adrenalectomy		- A B C D
Post hyposhysectomy		- A B C D
Post thyroidectomy		- A B C D
Metabolic Medication
Hydrocortisone		- A B C D
IM vasopressin (Pitressin)		- A B C D
Insulin		- A B C D
Prednisone		- A B C D
Radioactive iodine		- A B C D
Wound Management / Surgical Equipment and procedures
Assessment	Skin for impending breakdown	- A B C D
	Stasis ulcers	- A B C D
	Surgical wound healing	- A B C D
Equipment and procedures	Air fliudized, low airloss beds	- A B C D
	Sterile dressing changes	- A B C D
	Wound care / irrigations	- A B C D
Care of patient 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
Phlebotomy / IV Therapy Equipment and procedures
Administration of blood / blood products	Cryoprecipitate	- A B C D
	Packed red blood cells	- A B C D
	Plasma / albumin	- 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 Equipment and procedures
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
Administration of blood / blood products	Albumin / plasma	- A B C D
	Cryoprecipitate	- A B C D
	Packed red blood cells	- A B C D
	Whole blood	- A B C D
Phlebotomy / IV Therapy Care of patient with
Peripheral line / dressing		- A B C D
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
Pain Management Care of patient with
Assessment of pain level / tolerance		- A B C D
Care of the patient with	Anesthesia / analgesia	- A B C D
	IV conscious sedation	- A B C D
	Narcotic analgesia	- A B C D
	Patient controlled analgesia (PCA pump)	- 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.