Nurse Visit Checklist

Every Visit
Visit Type Immunizations Vitals Forms Labs/Tests
Newborn
NB records needed
1st Hep B usually done in hospital FULL Vitals: W, L, HR, HC, RR, T (rectal) Check NBMS Bilirubin (if needed)
Hell stick, invert tube to prevent clotting and spin
yellow top brown tube
2 weeks Full Vitals EPDS
Check NBMS
Bilirubin (if needed)
1 months Full Vitals EPDS H&H, reticulocyte (if needed)
Hell stick, invert blue tube to prevent clotting
Purple top clear tube
VERY IMPORTANT NOT TO CLOT (cannot run test if it clots)
2 months 1st Pentacel (DTap-Hib-IPV)
1st Prevnar (Pneumococcal)
1st Rotavirus (oral)
2nd hep B
Full Vitals EPDS
4 months 2nd Pentacel (DTap-Hib-IPV)
2nd Prevnar (Pneumococcal)
2nd Rotavirus (oral)
Full Vitals EPDS
6 months 2nd Pentacel (DTap-Hib-IPV)
2nd Prevnar (Pneumococcal)
2nd Rotavirus (oral)
Flu (has to be 6 months or older
Full Vitals EPDS
9 months 3rd Hep B
Flu
Full Vitals:
W, L, HC, HR, RR, T(tympanic or temporal)
Food/Safety Question
12 months VACCINES MUST BE GIVEN on or after 1st birthday
1st Hep A
1st MMR + sterile diluent(sub Q)
1st Varicella + sterile diluent(sub Q)
If chosen to separate, then they must be given at LEAST 30 days apart)
Flu
Full Vitals Food/Safety QUestion Fluoride (cannot eat or drink for 30 mins)
Hemoglobin
DO NOT let it clot
Purple top clear tube
15 months 4th Pentacel (DTap-Hib-IPV)
Cannot give past 5 yrs old
Flu
Full Vitals Food/Safety Questions
18 months 2nd Hep A (at least 6 mo after first)
flu
Full Vitals Food/Safety Questions
MCHAT
Fluoride
24 months Flu Full Vitals Food/Safety Questions Hemoglobin
Vision
30 months Flu Full Vitals Food/Safety Questions
MCHAT
3 years Flu Full Vitals:
W, H, HR, RR, T, BP
Food/Safety Question Vision
4 years VACCINES MUST BE GIVEN ON OR AFTER 4th birthday
Quadricel (DTap-IPV)
Proquad (MMR-Varivax)
Full Vitals Food Safety Question Vision
Hearing