GRADED
TRIAL
# 1
GRADED
TRIAL
# 2
NOTES
1. ✦ Check the physician’s orders.
2. ✦ Perform hand hygiene.
3. ✦ Prepare the equipment.
4. ✶ Test the equipment and make
sure the power is on.
5. ✶ Identify the patient, and explain
the procedure.
6. ✦ Establish a signal response
that the patient will give if no
automatic button is available;
nodding head and holding up
a finger are acceptable signals
(Figure A).
7. ✦ Have the patient assume a
comfortable position.
8. ✦ Place headphones over the
patient’s ears.
9. ✶ Begin with low frequency and
watch the patient for indication
that the sound is heard; push the
button to record if the machine
does not do it automatically.
10. ✶ Gradually increase the frequency
until the test is completed in the
first ear.
11. ✶ Proceed to the other ear and
repeat the entire procedure.
12. ✦ Remove the headphones.
13. ✦ Clean the equipment following the
manufacturer’s instructions.
POINT VALUE
✦ = 3–6 points
✶ = 7–9 points
Name: ________________________________________
Date: _________________________________________
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