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Nursing Practice 1 (NUR 0080) Neuro Assessment

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John Marsh
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Neuro Assessment

  • University of Pittsburgh
  • Foundations of Nursing Practice 1 (NUR 0080)

Lab Competency
Introduction:
Good morning ma’am. I am your student nurse; I will be assessing your neurological status. Do
you have any concerns or anything you wish to discuss?
I will begin by asking you to tell me your name, where you are, and what day it is.
My pt is AAOX3
My pt is awake and alert.
Vital signs taken earlier are
-temp of ______
-their pulse is ______
-their respiratory rate is ______ non-labored. I do not see any signs of respiratory
distress.
-Sats on room air are ______
-Their BP is ______
-Pain score (0-10) ______
Cranial Nerve Assessment
CN II- Optic
Cranial nerve two is the optic nerve. I am now going to check visual acuity using a
Handheld Snellen Chart. Please read the lowest line that you can see clearly. Have pt read line
with one eye covered, the other eye covered, and both eyes open. Report three numbers to
proctor. Pt scored a ___/____ which means what the average person can see at ____ ft, she can
see at ____ft. I am now going to check the visual fields. Please hold up a finger when you can
see my hand on each side. Wiggle fingers from the middle of the head, top of head, and bottom
of head. Pt’s visual fields are normal. I would check the optic disk with an ophthalmic scope.

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Nursing Practice 1 (NUR 0080) Neuro Assessment

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