THE OHIO STATE UNIVERSITY

RADIATION THERAPY PROGRAM

VITAL SIGNS COMPETENCY EVALUATIONS

______________________________ ____________________________
Students Name Date(s) Completed

The following is a checklist of all competencies that must be completed (with a 100%) at the finish of
the nursing rotation. The procedures must be performed without assistance but checked by a nurse.
Successful completion is at the discretion of the nurse clinical instructor.

BLOOD PRESSURE OBJECTIVES Yes No

1. Positioned patient with arm supported at heart level and legs uncrossed.

2. Sleeve was rolled up and loose.

3. Selected correct size cuff (20% greater than the diameter or 40%
of the circumference.
4. Extends arm palm up and palpates brachial artery.

5. Positions center of cuff bladder over brachial artery with bottom cuff edge
1 inch above bend of arm.
6. Places BP gauge at eye level with starting level at 0.

7. Estimates systolic pressure by palpating radial pulse. Waits 30 to 60 seconds

after palpation.
8. Places stethoscope over brachial artery and not under the cuff.

9. Quickly inflates cuff to 30 mmHg above the estimated systolic pressure.

10. Deflates cuff at 2-3 mmHg per second while listening for blood pressure.

11. Obtains systolic and diastolic pressures.

PULSE, RESPIRATION AND TEMPERATURE OBJECTIVES Yes No

1. Palpates radial pulse without using thumb and obtains correct pulse rate/min.

2. Verbalizes 3 locations a pulse can be taken other than the radial artery.

3. Observes chest for inhalation and exhalation and obtains correct

respiratory rate / min.
4. Utilizes the digital thermometer and obtains correct temperature.

5. Verbalizes normal adult parameters for BP, P and R and actions to take
if outside normal limits.

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Clinical Instructor Signature Student Signature
 THE OHIO STATE UNIVERSITY
RADIATION THERAPY PROGRAM
O2 COMPETENCY EVALUATIONS

_______________________________ ____________________________
Students Name Date(s) Completed

The following is a checklist of all competencies that must be completed (with a 100%) for respiratory
care. The procedures must be performed without assistance but checked by a clinical instructor.
Successful completion is at the discretion of the clinical instructor.

O2 Objectives Yes No

1. Determines the amount of O2 reading that is set on the O2 tank..

2. Sets wall flow meter to same reading as the O2 tank.

3. Disconnects O2 tubing from tank and reconnects to wall unit.

4. Shuts off tank.

5. Reverses procedure after patient’s treatment or exam.

5. Reads the tank regulator to determine amount of O2 left and defines if it is

satisfactory to return patient on remaining amount of O2 in tank.

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Clinical Instructor Signature Student Signature