OSCE BLOK 14 NAMA :………………………

9 NOVEMBER 2010 NIM : ……………………..

CHECK LIST FOR THYROID EXAMINATION

No ASPECTS TO BE SCORED 0 1 2 3
1 Maintaining courtesy: a. Say salaam at the beginning of interview, ask the objective of examination
2 Inspect: a. Ajust patient’’s neck for extention
b. Inspect lower os cricoid to examine the glandula thyroidea and report the result of the examination
3. Palpate:Examiner stands behind the patient’s
4. Put his two fingers below os cricoid, patients is asked to swallow
5. Examiner ckecks thyroid and reports the result of palpate examination :
0 = tidak terlihat dan tidak teraba
1 = tidak terlihat tapi teraba dengan palpasi
2 = teraba dengan palpasi dan terlihat waktu tengadah
3 = Sudah terlihat dari jarak minimal 3 meter
4 = Sudah terlihat dari jarak 10 meter
6. When enlargment happens, auscultation is done.Examiner can put stethoscope on lobus lat gland thyroidea & report the bruit.
7. Examiner cincludes the result of the examination in general
Total 21

ASPECTS TO BE SCORED 0 1 2 3
EDUCATION ON HOW TO INJECT INSULIN PEN
1 Explain how to put insulin tube on pen dan to put on pen needle.      
2 Explain how to arrange dosage/unit required by the equipment.      
3 Explain how to conduct aseptic procedure and how to conduct injection.      
4 Explain the locations that injection may take place.      
5 Explain how to recognize the symptoms of complication due to injection (signs of infections and hypoglycemia)      
EXAMINATION OF BLOOD GLUCOSE
6 Tools/ materials preparation: Autoclix/vaccinostyle, Alcohol 70%, Cotton, Blood glucose examination tools and
strip test ( test carik)
7 How to take the blood:
1.Clean patient’s ring finger using cotton that has been give alcohol 70%, dry it
2. Prick the ring finger tip using vaccinostyle vertically, fast and not deep
3. After blood comes out from the finger, sweep it with dry sterililzed cotton and Push the fingertip outward
4. Turn the hand up side down. Allow the blood drop alittle and Drop the blood on the strip test
5. Conduct the examination procedure in line with the instruction of each testing tools
8 How to use glucometer: 6. If the strip test picture appears, put the strip test in
7. Touch the blood drop until filling the central test area.
8. Read the blood glucose that appears
Total Score = 24

CHECK LIST - EDUCATION ON DM DIET

ASPECTS TO BE SCORED 0 1 2 3
1 Explain the diet objectives in DM management.      
2 Count calorie needs of DM client diet : A. Count the ideal body weight      
3 B. Determine client’s normal/under/over weight      
4 C. Count the calorie basal total relating to sex.
5 D. Count the basal calorie correction (regarding the age, activity, stress, pregnancy, lactation, and body weight)
6 Implement the result of calorie counting:      
A. Into the table of diabetic standard diet (in food exchange)      
B. To arrange menu example relating to food exchange table (exchange list) relating to the result of (6).
7 Explain about the needs of pair/family support towards the success of DM diet.
TOTAL SCORE = 21

CHECKLIST EDUKASI DM

No Aspek yang dinilai 0 1 2 3

1 Salam, memperkenalkan diri dan menjelaskan tindakan yang akan dilakukan ( menanyakan sampai sejauh
mana pengetahuan pasien tentang DM)
2 Menjelaskan tentang tujuan penatalaksanaan DM (jangka panjang dan jangka pendek)
3 Menjelaskan tentang 4 pilar penatalaksanaan DM (edukasi, gizi medis, jasmani, farmakologis)
EDUKASI DM (4 langkah)
4 I. Kenali diabetes Anda
5 II. Kenali ABC
6 III. Kelola diabetes
7 IV. Dapatkan perawatan secara rutin
8 Membuat kesimpulan, mengecek kemampuan menyerap informasi dan memberikan kesempatan untuk
bertanya (feedback)
9 Salam penutup
Jumlah = 27
Leg Exercise
0 1 2 3
Initial Position:
Sit down straight up on a bench and do not lean
1st exercise (10 times)
1.Move the toes from both legs like pawing
2.Straighten them back

2nd exercise (10 times)

1.Lift the toe tips, heels remain on floor
2.Put down the toe tips, then lift the heels and then put down back
again.

3rd exercise (10 times)

1.Lift toe tips of your both feet.
2.Spin your ankle sideways.
3.Put them down on the floor and move to the central side.

4th exercise (10 times)

1.Lift your both heels.
2.Spin your heels sideways.
3.Put them down again on the floor and move to the central side.

5th exercise (each leg 10 times)

1.Lift one of the knees
2.Straighten your legs.
3.Move your toes forwards.
4.Put your leg down again, left and right legs take turns.

6th exercise (each leg 10 times)

1.Straighten one of your legs on the floor.
2.Lift the leg.
3.Move the toe tips towards your face. Put down back the hell on
the floor

7th exercise (10 times)

Like the prior exercise (exercise 6) but this time, with both legs at
the same time.

8th exercise (10 times)

1.Lift your both legs, straighten and hold on the position.
2.Move your ankles forwards and backwards.

9th exercise (each leg 10 times)

1.Straighten one of your legs and lift it.
2.Spin the ankle.
3.Write on the air number 0 – 10 using your leg.

10th exercise (once)

1.A piece of newspaper folded in the form of a ball using feet. Then
make it as before folded using both feet and afterwards, tear it up.
2.Collect the torn pieces with both feet and put on other piece of
newspaper. Finally, wrap all in the form of a ball with your both feet.