TRINITY VALLEY COMMUNITY COLLEGE ASSOCIATE DEGREE NURSING
CLINICAL II and TRANSITION CLINICAL
Student Name:_________________________________
RUBRIC FOR PEDIATRIC ASSESSMENT
CONCEPT
HUMAN
DEVELOPMENT
EXEMPLARY
AVERAGE
6
5
Compared and contrasted the normal
growth/development of pediatric patient to
the “textbook picture” of the specific age
group including activity restrictions.
Addressed all areas including 1) Gross
motor; 2) Fine motor; 3) Language; 4)
Socialization; 5) Cognition; 6) Sensory
(Discussed all 5 senses - tactile, auditory,
etc.). Gave specific descriptive 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
1.75
Completed 3 growth charts (available online) (stature for age, weight for age, and
stature for weight or BMI) and graphed
accurately. Analyzed data correctly stating
the percentiles from each chart.
1
Correctly identified the major
developmental task (Erikson) for this child.
Stated whether child was meeting or not
meeting task and gave rationale.
4
3
Compared and contrasted the normal
growth/development of pediatric
patient to the “textbook picture” of the
specific age group including activity
restrictions but omitted one or more
areas. Examples were not very
descriptive or were exactly what was
written in the textbook. Comparison
included that child was meeting
current level.
1
Identified at least 5 play/activities and 5
toys that would be appropriate for the child
according to the developmental level and
physical condition/illness.
PERFUSION
GAS EXCHANGE
THERMOREGULATION
INTERPERSONAL
RELATIONSHIPS
1
Listed patient’s vital signs and “normal”
vital signs for a child of the same age.
Compared and analyzed the vital signs
correctly. If not within normal limits gave
suggested explanation for aberrancy.
1
Described interactions between 1) child and
Total Points (Grade)______________________
UNSATISFACTORY
OMITTED
GRADE
2
1
0
Listed the normal growth/ development
Did not complete
of pediatric patient to the “textbook
section.
___pts
picture” of the specific age group
including activity restrictions but didn’t
compare and contrast with an analysis.
1.5
1.25
At least one of the growth charts was
not graphed correctly. Or analysis was
given that included at least one
incorrect percentile.
1
0.75
More than one of the growth charts was
not graphed correctly. No analysis was
given.
0
Did not complete
section.
____pts
0.75
Correctly identified the major
developmental task (Erikson) for this
child. Stated whether child was
meeting or not meeting task but didn’t
give adequate rationale.
0.75
Identified at least 3 play/activities and
3 toys that would be appropriate for
the child according to the
developmental level and physical
condition/illness.
0.75
At least one of the vital signs were not
analyzed correctly. No explanation for
abnormal vital sign was given.
0.5
Misidentified the major developmental
task (Erikson) for this child or did not
state whether child was meeting or not
meeting task.
0
Did not complete
section.
____pts
0.5
Identified play/activities and toys that
would not be appropriate for the child
according to the developmental level and
physical condition/illness. Or identified
less than 3 of each.
0.5
More than one of the vital signs were not
analyzed correctly or there was no
analysis given.
0
Did not complete
section.
____pts
0
Did not complete
section.
____pts
0.75
Described interactions between 1)
0.5
Omitted one or more of the required
0
Did not complete
166
____pts
CONCEPT
NUTRITION
IMMUNITY
EVIDENCE-BASED
PRACTICE
HEALTH
PROMOTION
SAFETY
PROFESSIONALISM
EXEMPLARY
primary caregiver; 2) child and nursing
student; and 3) primary caregiver and
student. Was descriptive and included at
least 3 sentences for each.
2
1.75
Described typical nutritional intake of
pediatric patient. Listed the recommended
number of servings for each food group for
this age child. Determined number of
servings child consumed and compared
with recommended number of servings.
Included analysis of the findings.
2
1.75
Listed immunizations that are required for
this age child in provided table. Listed
immunizations that the child received at
what age. Provided analysis of current
immunization status. Identified and
discussed primary caregiver’s knowledge of
immunizations including side effects,
adverse effects and safety measures for
patient and patient contacts and list at least
one teaching need.
1
Discussed one evidence-based nursing
practice guideline related to health
promotion of children this age. Included
reference
1
Identified at least 6 health promotion
activities for this age child.
1
Identified at least 10 safety precautions for
this age child.
1
Accurate spelling, & grammar (< 2 errors
per submission), and references cited
correctly in APA format.
Criteria sheet submitted.
AVERAGE
child and primary caregiver; 2) child
and nursing student; and 3) primary
caregiver and student but was not
descriptive and was too brief.
1.5
1.25
Described typical nutritional intake of
pediatric patient. Listed the
recommended number of servings for
each food group for this age child and
determined number of servings child
consumed and compared with
recommended number of servings. Did
not include analysis of the findings or
analysis was incorrect for at least one
area.
1.5
1.25
Listed immunizations that are required
for this age child in provided table.
Listed immunizations that the child
received at what age. Provided
analysis of current immunization status
that was incorrect in at least one area.
Did not adequately discuss primary
caregiver’s knowledge of
immunizations including side effects,
adverse effects and safety measures for
patient and patient contacts and list at
least one teaching need.
0.75
Discussed one evidence-based practice
guideline but it was not related to
health promotion. Reference included.
0.75
Identified at least 4 health promotion
activities for this age child.
0.75
Identified at least 6 safety precautions
for this age child.
0.75
Accurate spelling & grammar (< 5
errors per submission), but references
not in APA format.
Criteria sheet submitted.
167
UNSATISFACTORY
descriptions of interactions.
OMITTED
section.
1
0.75
Described typical nutritional intake of
pediatric patient. Listed the
recommended number of servings for
each food group for this age child but did
not determine number of servings child
consumed and compared with
recommended number of servings nor
include analysis of the findings. Or
determination of servings consumed and
analysis was incorrect.
1
0.75
Listed immunizations that are required
for this age child in provided table.
Listed immunizations that the child
received at what age. Did not provide
analysis of current immunization status
in all areas. Did not adequately discuss
primary caregiver’s knowledge of
immunizations including side effects,
adverse effects and safety measures for
patient and patient contacts and list at
least one teaching need.
0
Did not complete
section.
____pts
0
Did not complete
section.
____pts
0.5
Discussed practice guideline related to
health promotion that was not evidencebased.
Reference not included.
0.5
Identified at least 2 health promotion
activities for this age child.
0.5
Identified at least 3 safety precautions for
this age child.
0.5
Accurate spelling & grammar (> 5 errors
per submission), and no references cited.
Criteria sheet submitted.
0
Did not complete
section.
____pts
0
Did not complete
section.
0
Did not complete
section.
0
No criteria sheet
GRADE
____pts
____pts
___pts
TRINITY VALLEY COMMUNITY COLLEGE
ASSOSCIATE DEGREE NURSING
PEDIATRIC ASSESSMENT – LEVEL II & TRANSITION
Student Name: ________________________________
Patient’s Initials: ____Age: _____ Sex: _______
Course: _________________
Date of Contact: ________________
(Must not be own child)
I.
Human Development
Growth & Development
Component Area
Textbook – What is
Expected for Age
Gross motor
Fine motor
Language
Socialization
Cognition
Sensory - Vision
168
Client – What Client
Demonstrated
Analysis – Compare
& Contrast
Sensory – Auditory
Sensory – Tactile
Sensory – Taste
Sensory – Smell
Reference:
Summary of Analysis:
I. Human Development - Growth Charts
Instructions
1. Measure client’s height and weight
2. Calculate client’s BMI
3. Download growth charts from CDC
a. Height for age
b. Weight for age
169
c. BMI
4. Graph client information on the growth chart and submit. Do not submit computer
generated results
5. 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:
1. Identify play activities and toys that would be appropriate for this age child
a. Play activities
170
b. Toys
Reference:
II. Perfusion, Gas Exchange & Thermoregulation - Vital Signs
Client’s Results
Age Appropriate
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
171
Analysis
Between child and the
nursing student
IV. Nutrition
Instructions:
1. Ask primary caregiver to describe average nutritional intake for child for a day or ask
them to write down intake for a typical day.
2. Go to choosemyplate.gov and find out the recommended number of servings in each food
group for this child
3. Determine the number of servings and calories the patient consumed
4. Determine the difference between the actual intake and the recommended intake
5. Write an analysis of the nutritional intake.
Breakfast:
Snacks:
Lunch:
Snacks:
Dinner:
Snacks:
Food Group
# Servings
Recommended for this
age child
Grains
Proteins
Fruits
Vegetables
Dairy
Reference:
Analysis of results and recommendations:
172
# Servings Patient
Consumed in average
day
Difference
(+ or -)
V. Immunity
Immunizations
Recommended (Use
Texas website)
Recommended Ages
When They Should Be
Received
Age When Client
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):
173
Analysis
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:
174
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:
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Revised 01/14