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Professional Nursing I (NUR 3805) Head To Toe Assessment Guide

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Sandra Watson
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Florida International University

Professional Nursing I (NUR 3805)

Head to Toe Assessment
 Perform Hand Hygiene and Provide Privacy to patient
 PRESENT YOURSELF
-Hello, my name is Randy Chavez and I need to perform a head to toe assessment on you.
Is that ok with you?
 LOOK AT PATIENT’S ARM BAND
– (This will help you to have the right patient)-
 -Ask Patient all personal information in the Band to help you check their NEUROSTATUS
-Can you tell me where we at?
-Can you tell me what we are doing today?
-Can you tell me who is the President of the U.S?
(If Patient responds to all questions correctly, you can say that patient is ORIENTED AND ALERT x
3)
 VITAL SIGNS
-Heart rate (60-100 bpm)
-Blood Pressure (119/79)
-Temperature (98.6)
-Oxygen Saturation (75-100 mm of mercury)
-Respiratory Rate (12-20 Breaths per minute)
-Patient Pain Rate
 Ask Patient: -Are you having any pain on a scale of 0-10, zero for the less
pain and 10 for the worse pain you have ever had?
 COLLECT HEIGHT, WEIGHT, BMI
BMI: -less than 18.5 (underweight)
-more than 30 (obese)
WHY WE ASK ALL THESE QUESTIONS?…
-Why are we asking all these questions and
taking vital signs to the patient?
A/ The meaning of all done above is to collect
all information from the patient and check for:
-Patient’s Emotional Status: (are they calmed,
agitated, drowsy?), in fact just to see what’s
going on with the patients.
-To check if they look their stated age.
-To check if the skin color matches their
ethnicity?
-To check if they understand all the questions
and see if they can hear well, or if is a delay
on their responses.
-To notice while talking any masses, lesions,
amputations, skin sweaty.
-To check if their hygiene is good?
-To check if their posture is good?
-To check for any abnormal smell.
Then move on to HEAD
 First, Inspect the head.

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Professional Nursing I (NUR 3805) Head To Toe Assessment Guide

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