Download Practicum 13-1:

Name:______________________________
Date:__________________________
Procedure 45-2
Perform and Record Pediatric Vital Signs and Vision
Screening
Objective: The student, using the supplies and equipment listed below, will
demonstrate how to measure a child’s temperature, pulse, respirations, and blood pressure
and perform a vision screening test.
Supplies: pediatric blood pressure cuff, Snellen E chart, watch with a sweeping second
hand, digital thermometer, patient chart
Affective Behaviors: Affective behaviors provide a professional approach to a skill that
enhances the patient encounter. These behaviors may also display sensitivity to patient’s
rights and enhance communication. Pay close attention to these skills which will be in
bold, italicized font.
Notes to the Student:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Skills Assessment Requirements
Read and familiarize yourself with the procedure; complete the minimum practice
requirements. Document each MPR using proper charting technique. Complete each
procedure within a reasonable amount of time, with a minimum of 85% accuracy.
Name:______________________________
Date:__________________________
POINT VALUE
 = 3-6 points
 = 7-9 points
Pulse, Respirations,
Axillary Temperature,
and Blood Pressure
1. 
2. 
3. 
4. 
5. 
6. 
7. 
8. 
9. 
Gather equipment and supplies.
Wash your hands.
Greet and identify the patient,
introduce yourself and explain
the procedure to the parent or
guardian.
Have the parent disrobe the
child down to the diaper.
Recognize and communicate
with the patient at his or her
own level of understanding.
Place the child in the supine
position or allow him or her to
remain in the parent’s lap for
greater compliance.
Locate the apex of the heart by
feeling for the fifth intercostal
space to the left of the sternum
on the midclavicular line.
Make sure the stethoscope head
is warmed and place it on the
space, listening for the “lubdub” of the heart. Count for 1
minute (each lub-dub equals
one beat).
Record the results.
Place your hand on the child’s
chest and count inspirations and
expirations for 1 minute. The
rise and fall of the chest is
counted as one breath.
Record the results.
PRACTICE
TRIAL
GRADED
TRIAL
#1
GRADED
TRIAL
#2
NOTES:
Name:______________________________
Date:__________________________
10. 
11. 
12. 
13. 
Take the temperature probe and
apply a disposable sheath.
Place the probe in the infant’s
axillary space, holding the
child’s arm down close to his or
her side.
Wait for the beep to indicate the
reading has been completed,
then dispose of the probe cover.
Record the results.
14. 
If the physician orders that
blood pressure be taken,
follow the directions for taking
an adult BP reading.
15. 
Palpate the blood pressure first
to avoid over-inflating the cuff.
Make sure the cuff size is
correct for the patient size.
Record the results.
16. 
Vision Screening
17. 
Take the child to the vision
screening area,
accompanied by the parent.
Explain the chart and ask the
child to stand at the correct
distance from the chart. (Each
chart indicates the
recommended distance.)
Name:______________________________
Date:__________________________
18. 
19. 
20. 
Have the child cover one eye
and read as many lines
as possible. If the child misses
two objects, directions, or
letters in a single line, stop the
test and record the line number.
For example, if the child reads
line 20/20 correctly with the left
eye but misses multiple letters
on line 20/15, the vision would
be 20/20 in the left eye.
Repeat the procedure for the
other eye, then both
eyes reading together. Escort
the patient back to the
examination room if
necessary. Ask the
parent/guardian if he or she
has any questions prior to
leaving the examination room.
Record the results in the
patient’s chart. Sign the
completed entry with your
name and credentials.
Name:______________________________
Date:__________________________
Document: Enter the correct information in the chart below.
Grading
Points Earned
________
Points Possible
________
Percent Grade
________
144
144
 YES
 YES
 NO
 NO
 N/A
 N/A
(Points Earned/Points Possible)
PASS:
________
Instructor Sign-Off
Instructor:___________________________________________ Date:___________