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 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”. / 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. / 2 1
Listed the normal growth/ development of pediatric patient to the “textbook picture” of the specific age group including activity restrictions but didn’t compare and contrast with an analysis. / 0
Did not complete section. / ___pts

2 1.75

Completed 3 growth charts (available on-line) (stature for age, weight for age, and stature for weight or BMI) and graphed accurately. Analyzed data correctly stating the percentiles from each chart.

/ 1.5 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
1
Correctly identified the major developmental task (Erikson) for this child. Stated whether child was meeting or not meeting task and gave rationale. / 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. / 0.5
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

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.

/ 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. / 0.5
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
Did not complete section. / ____pts
PERFUSION
GAS EXCHANGE
THERMO-REGULATION / 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.

/ 0.75
At least one of the vital signs were not analyzed correctly. No explanation for abnormal vital sign was given. / 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
INTERPERSONAL
RELATIONSHIPS / 1
Described interactions between 1) child and primary caregiver; 2) child and nursing student; and 3) primary caregiver and student. Was descriptive and included at least 3 sentences for each. / 0.75
Described interactions between 1) child and primary caregiver; 2) child and nursing student; and 3) primary caregiver and student but was not descriptive and was too brief. / 0.5
Omitted one or more of the required descriptions of interactions. / 0
Did not complete section. / ____pts
NUTRITION / 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. / 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 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. / 0
Did not complete section. / ____pts
IMMUNITY / 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. / 1.5 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. / 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
EVIDENCE-BASED PRACTICE / 1
Discussed one evidence-based nursing practice guideline related to health promotion of children this age. Included reference / 0.75
Discussed one evidence-based practice guideline but it was not related to health promotion. Reference included. / 0.5
Discussed practice guideline related to health promotion that was not evidence-based.
Reference not included. / 0
Did not complete section. / ____pts
HEALTH PROMOTION /

1

Identified at least 6 health promotion activities for this age child.

/ 0.75
Identified at least 4 health promotion activities for this age child. / 0.5
Identified at least 2 health promotion activities for this age child. / 0
Did not complete section. / ____pts
SAFETY /

1

Identified at least 10 safety precautions for this age child.

/ 0.75
Identified at least 6 safety precautions for this age child. / 0.5
Identified at least 3 safety precautions for this age child. / 0
Did not complete section. / ____pts
PROFESSION-ALISM /

1

Accurate spelling, & grammar (< 2 errors per submission), and references cited correctly in APA format.
Criteria sheet submitted. / 0.75
Accurate spelling & grammar (< 5 errors per submission), but references not in APA format.
Criteria sheet submitted. / 0.5
Accurate spelling & grammar (> 5 errors per submission), and no references cited.
Criteria sheet submitted. / 0
No criteria sheet / ___pts

1

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)

  1. Human Development
Growth & Development
Component Area / Textbook – What is
Expected for Age / Client – What Client Demonstrated / Analysis – Compare & Contrast
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
  1. Measure client’s height and weight
  2. Calculate client’s BMI
  3. Download growth charts from CDC
  1. Height for age
  2. Weight for age
  3. BMI (If child is over 2- otherwise do height for weight chart)
  1. Graph client information on the growth chart and submit. Do not submit computer generated results
  2. 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

  1. Play activities

  1. 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:
  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 / # Servings Patient Consumed in average day / Difference
(+ or -)
Grains
Proteins
Fruits
Vegetables
Dairy
Reference:
Analysis of results and recommendations:
V. Immunity
Immunizations Recommended (Use Texas website) / Recommended Ages When They Should Be Received / Age When Client Received Immunizations / Analysis
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:

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