CDAMP Take & Record Vital Signs (click here to download)

CDAMP  MODULE V skill: Take and Record Vital Signs (Complete this skill on 4 patients, use separate sheets for each skill)

EVALUATION: Take and Record Vital Signs                                 

STUDENT NAME ______________________________ID#___________

DATE _____________________________PATIENT’S INITIALS___________

Materials: 0 –10 points

  The following armamentarium is present:

___   Gloves, wrist watch with second hand, digital thermometer, disposable

         plastic sheaths, disinfectant,  2×2 gauze sponges, stethoscope,

         sphygmomanometer, patient’s chart, pen

Steps:   0 – 10 points each

Obtains & Records Pulse:          

___  1.  Seats patient upright

___  2.  Washes hands and gloves up

___  3.  Explains procedure

___  4.  Instructs patient to rest wrist on arm of chair or counter

___  5.  Locates radial pulse with pads of first three fingers over wrist

___  6.  Gently compresses radial artery so that pulse can be felt

___  7.  Using second hand on watch, counts number of pulsations for 30

              seconds, and notes any irregular rhythm patterns

___  8.  Keeping fingers on pulse, counts rise and fall of chest for 30 seconds

___  9.  Multiplies pulse and respiration counts by 2 and records on paper

             along with any evidence of rhythm irregularities

Obtains and Records Temperature:

___10. Places a disposable sheath over tip of digital thermometer

___11. Explains procedure to patient

___12. Turns on thermometer and when display shows it is ready, gently

            places tip under patient’s tongue

___13. Leaves in place until display indicates final reading, then removes

            from patient’s mouth

___14. Records the reading on paper

___15. Turns off thermometer and disinfects thermometer as recommended

             by manufacturer      

Obtains and Records Blood Pressure:

___16. Explains procedure to patient and instructs patient to extend arm at

            heart level

___17. Places blood pressure cuff around patient’s arm about 1 inch above

            antecubital space and secures it in place

___18. Opens valve to expel any air from cuff

___19. Positions ear pieces of stethoscope in a forward manner into the ears

___20. Places diaphragm of stethoscope over brachial artery, securing in

            place with thumb.  Places other fingers under elbow to hyperextend 


___21. Locks bulb valve and inflates cuff using pumping pressure on bulb

            until inflation level reaches a reading of 160 – 180

___22. Deflates cuff at a rate of 2 – 4 millimeters of mercury per second by

            slightly releasing the bulb valve

___23. Notes reading when first detecting a distinct thumping sound

            (systolic pressure)

___24. Continues to slowly deflate pressure listening to pulsing sounds to note when

            all sounds disappear (diastolic pressure).

___25. Rapidly deflates cuff and removes from arm

___26. Correctly records reading on paper, indicating which arm was used

___27. Disinfects ear pieces and diaphragm of stethoscope according to manufacturer’s


___28. Removes gloves and washes hands

___29. Records vital signs on patient’s chart


Preceptor declares skill was successfully completed.   (75% of total possible points)

PRECEPTOR’S  SIGNATURE __________________________________

STUDENT’S SIGNATURE _____________________________________