Trinity Valley Community College
TRINITY VALLEY COMMUNITY COLLEGE ASSOCIATE DEGREE NURSING Student Name:_________________________________
CLINICAL II and TRANSITION CLINICAL
RUBRIC FOR PEDIATRIC ASSESSMENT
Total Points (Grade)______________________
|CONCEPT |EXEMPLARY |AVERAGE |UNSATISFACTORY |OMITTED |GRADE |
|HUMAN DEVELOPMENT |6 |4 |2 |0 | |
| |5 |3 |1 |Did not complete section.| |
| |Compared and contrasted the normal |Compared and contrasted the normal |Listed the normal growth/ development of | |___pts |
| |growth/development of pediatric patient to the |growth/development of pediatric patient to |pediatric patient to the “textbook picture” of | | |
| |“textbook picture” of the specific age group |the “textbook picture” of the specific age |the specific age group including activity | | |
| |including activity restrictions. Addressed all |group including activity restrictions but |restrictions but didn’t compare and contrast | | |
| |areas including 1) Gross motor; 2) Fine motor; 3) |omitted one or more areas. Examples were not|with an analysis. | | |
| |Language; 4) Socialization; 5) Cognition; 6) |very descriptive or were exactly what was | | | |
| |Sensory (Discussed all 5 senses - tactile, |written in the textbook. Comparison included| | | |
| |auditory, etc.). Gave specific descriptive |that child was meeting current level. | | | |
| |examples of child meeting or not meeting the tasks| | | | |
| |that did not copy what the textbook said. | | | | |
| |Comparison included more analysis than “meeting | | | | |
| |current level”. | | | | |
| |2 |1.5 |1 |0 | |
| |1.75 |1.25 |0.75 |Did not complete section.|____pts |
| |Completed 3 growth charts (available on-line) |At least one of the growth charts was not |More than one of the growth charts was not | | |
| |(stature for age, weight for age, and stature for |graphed correctly. Or analysis was given |graphed correctly. No analysis was given. | | |
| |weight or BMI) and graphed accurately. Analyzed |that included at least one incorrect | | | |
| |data correctly stating the percentiles from each |percentile. | | | |
| |chart. | | | | |
| |1 |0.75 |0.5 |0 | |
| |Correctly identified the major developmental task |Correctly identified the major developmental|Misidentified the major developmental task |Did not complete section.|____pts |
| |(Erikson) for this child. Stated whether child was|task (Erikson) for this child. Stated |(Erikson) for this child or did not state | | |
| |meeting or not meeting task and gave rationale. |whether child was meeting or not meeting |whether child was meeting or not meeting task. | | |
| | |task but didn’t give adequate rationale. | | | |
| |1 |0.75 |0.5 |0 | |
| |Identified at least 5 play/activities and 5 toys |Identified at least 3 play/activities and 3 |Identified play/activities and toys that would |Did not complete section.|____pts |
| |that would be appropriate for the child according |toys that would be appropriate for the child|not be appropriate for the child according to | | |
| |to the developmental level and physical |according to the developmental level and |the developmental level and physical | | |
| |condition/illness. |physical condition/illness. |condition/illness. Or identified less than 3 of| | |
| | | |each. | | |
|PERFUSION |1 |0.75 |0.5 |0 | |
|GAS EXCHANGE | | |More than one of the vital signs were not |Did not complete section.|____pts |
|THERMO-REGULATION |Listed patient’s vital signs and “normal” vital |At least one of the vital signs were not |analyzed correctly or there was no analysis | | |
| |signs for a child of the same age. Compared and |analyzed correctly. No explanation for |given. | | |
| |analyzed the vital signs correctly. If not within|abnormal vital sign was given. | | | |
| |normal limits gave suggested explanation for | | | | |
| |aberrancy. | | | | |
|INTERPERSONAL |1 |0.75 |0.5 |0 | |
|RELATIONSHIPS | |Described interactions between 1) child and |Omitted one or more of the required |Did not complete section.|____pts |
| |Described interactions between 1) child and |primary caregiver; 2) child and nursing |descriptions of interactions. | | |
| |primary caregiver; 2) child and nursing student; |student; and 3) primary caregiver and | | | |
| |and 3) primary caregiver and student. Was |student but was not descriptive and was too | | | |
| |descriptive and included at least 3 sentences for |brief. | | | |
| |each. | | | | |
|NUTRITION |2 |1.5 |1 |0 | |
| |1.75 |1.25 |0.75 |Did not complete section.|____pts |
| |Described typical nutritional intake of pediatric |Described typical nutritional intake of |Described typical nutritional intake of | | |
| |patient. Listed the recommended number of |pediatric patient. Listed the recommended |pediatric patient. Listed the recommended | | |
| |servings for each food group for this age child. |number of servings for each food group for |number of servings for each food group for this| | |
| |Determined number of servings child consumed and |this age child and determined number of |age child but did not determine number of | | |
| |compared with recommended number of servings. |servings child consumed and compared with |servings child consumed and compared with | | |
| |Included analysis of the findings. |recommended number of servings. Did not |recommended number of servings nor include | | |
| | |include analysis of the findings or analysis|analysis of the findings. Or determination of | | |
| | |was incorrect for at least one area. |servings consumed and analysis was incorrect. | | |
|IMMUNITY |2 |1.5 |1 |0 | |
| |1.75 |1.25 |0.75 |Did not complete section.|____pts |
| |Listed immunizations that are required for this |Listed immunizations that are required for |Listed immunizations that are required for this| | |
| |age child in provided table. Listed immunizations|this age child in provided table. Listed |age child in provided table. Listed | | |
| |that the child received at what age. Provided |immunizations that the child received at |immunizations that the child received at what | | |
| |analysis of current immunization status. |what age. Provided analysis of current |age. Did not provide analysis of current | | |
| |Identified and discussed primary caregiver’s |immunization status that was incorrect in at|immunization status in all areas. Did not | | |
| |knowledge of immunizations including side effects,|least one area. Did not adequately discuss |adequately discuss primary caregiver’s | | |
| |adverse effects and safety measures for patient |primary caregiver’s knowledge of |knowledge of immunizations including side | | |
| |and patient contacts and list at least one |immunizations including side effects, |effects, adverse effects and safety measures | | |
| |teaching need. |adverse effects and safety measures for |for patient and patient contacts and list at | | |
| | |patient and patient contacts and list at |least one teaching need. | | |
| | |least one teaching need. | | | |
|EVIDENCE-BASED PRACTICE |1 |0.75 |0.5 |0 | |
| |Discussed one evidence-based nursing practice |Discussed one evidence-based practice |Discussed practice guideline related to health |Did not complete section.|____pts |
| |guideline related to health promotion of children |guideline but it was not related to health |promotion that was not evidence-based. | | |
| |this age. Included reference |promotion. Reference included. |Reference not included. | | |
|HEALTH PROMOTION |1 |0.75 |0.5 |0 | |
| | |Identified at least 4 health promotion |Identified at least 2 health promotion |Did not complete section.|____pts |
| |Identified at least 6 health promotion activities |activities for this age child. |activities for this age child. | | |
| |for this age child. | | | | |
|SAFETY |1 |0.75 |0.5 |0 | |
| | |Identified at least 6 safety precautions for|Identified at least 3 safety precautions for |Did not complete section.|____pts |
| |Identified at least 10 safety precautions for this|this age child. |this age child. | | |
| |age child. | | | | |
|PROFESSION-ALISM |1 |0.75 |0.5 |0 | |
| |Accurate spelling, & grammar (< 2 errors per |Accurate spelling & grammar (< 5 errors per |Accurate spelling & grammar (> 5 errors per |No criteria sheet |___pts |
| |submission), and references cited correctly in APA|submission), but references not in APA |submission), and no references cited. | | |
| |format. |format. |Criteria sheet submitted. | | |
| |Criteria sheet submitted. |Criteria sheet submitted. | | | |
TRINITY VALLEY COMMUNITY COLLEGE
ASSOSCIATE DEGREE NURSING
PEDIATRIC ASSESSMENT – LEVEL II & TRANSITION
Student Name: ________________________________ Course: _________________
Patient’s Initials: ____Age: _____ Sex: _______ Date of Contact: ________________
(Must not be own child)
|Human Development |
|Growth & Development |
|Component Area |Textbook – What is |Client – What Client |Analysis – Compare & Contrast |
| |Expected for Age |Demonstrated | |
|Gross motor | | | |
| | | | |
| | | | |
|Fine motor | | | |
| | | | |
|Language | | | |
| | | | |
|Socialization | | | |
| | | | |
|Cognition | | | |
| | | | |
|Sensory - Vision | | | |
| | | | |
|Sensory – Auditory | | | |
| | | | |
|Sensory – Tactile | | | |
| | | | |
|Sensory – Taste | | | |
| | | | |
|Sensory – Smell | | | |
| | | | |
|Reference: |
|Summary of Analysis: |
| |
| |
| |
|I. Human Development - Growth Charts |
|Instructions |
|Measure client’s height and weight |
|Calculate client’s BMI |
|Download growth charts from CDC |
|Height for age |
|Weight for age |
|BMI (If child is over 2- otherwise do height for weight chart) |
|Graph client information on the growth chart and submit. Do not submit computer generated results |
|Analyze results and write summary – include description of percentiles |
|Client Height: |
|Client Weight: |
|Client BMI: |
| Summary of analysis of results: |
| |
| |
| |
| |
|I. Human Development - Erickson Stages of Development |
|Major developmental task |Give examples that show patient is |
| |meeting or not meeting the task |
| | |
| | |
|Is child meeting or not meeting task? | |
|I. Human Development - Play Activities |
|Instructions: |
|Identify play activities and toys that would be appropriate for this age child |
|Play activities |
| |
| |
|Toys |
| |
| |
|Reference: |
|II. Perfusion, Gas Exchange & Thermoregulation - Vital Signs |
| |Age Appropriate |Client’s Results |Analysis |
|Pulse | | | |
|Respirations | | | |
|Temperature | | | |
|Blood Pressure | | | |
|Reference: |
|Summary of analysis of results: |
| |
| |
|III. Interpersonal Relationships |
|Directions: Describe interactions: |
|Between child and primary caregiver | |
|Between primary caregiver and the nursing| |
|student | |
|Between child and the nursing student | |
|IV. Nutrition |
|Instructions: |
|Ask primary caregiver to describe average nutritional intake for child for a day or ask them to write down intake for a typical |
|day. |
|Go to and find out the recommended number of servings in each food group for this child |
|Determine the number of servings and calories the patient consumed |
|Determine the difference between the actual intake and the recommended intake |
|Write an analysis of the nutritional intake. |
|Breakfast: | |
|Snacks: | |
|Lunch: | |
|Snacks: | |
|Dinner: | |
|Snacks: | |
| |
|Food Group |# Servings Recommended for this |# Servings Patient Consumed in |Difference |
| |age child |average day |(+ or -) |
|Grains | | | |
|Proteins | | | |
|Fruits | | | |
|Vegetables | | | |
|Dairy | | | |
|Reference: |
|Analysis of results and recommendations: |
| |
| |
| |
| |
| |
| |
| |
| |
|V. Immunity |
|Immunizations Recommended (Use |Recommended Ages When They Should |Age When Client Received |Analysis |
|Texas website) |Be Received |Immunizations | |
|Hepatitis B | | | |
|Rotavirus | | | |
|Diphtheria, Pertussus, Tetanus | | | |
|Haemophilus influenza type B | | | |
|Pneumococcal | | | |
|Inactivated Polio | | | |
|Measles, Mumps, Rubella | | | |
|Varicella | | | |
|Reference (Use current Texas website and not textbook): |
|Summary of analysis of results: |
| |
| |
|Discuss primary caregiver’s knowledge of immunizations including side effects, adverse effects, and safety measures for patient and|
|patient contacts and analyze teaching needs: |
| |
| |
| |
| |
|VI. Evidence-based Nursing Practice |
|Instructions: Discuss one evidence-based nursing practice guideline related to health promotion of children this age |
|Evidence-based Nursing Practice Guideline: |
| |
| |
| |
| |
| |
| |
|Reference: |
|VII. Health Promotion |
|Instructions: Identify health promotion activities and safety precautions that would be appropriate for this age child |
|Health Promotion Activities |
| |
| |
| |
| |
| |
| |
| |
|Reference: |
|VIII. Safety |
|Instructions: Identify safety precautions that would be appropriate for this age child |
|Safety Precautions |
| |
| |
| |
| |
|Reference: |
N:\Syllabus\CBC Curriulum\Clinical II & Transition Pediatric Assessment Reviewed 04/15
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