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Full Neuro exam?

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Do RNs generally do a full neurologic exam in the ED given the time constraint (mental status, cranial nerves, motor exam, reflexes, coordination/gait, sensory)?

No, not a "nursing school" neuro exam. With pts that I concerned re stroke or bleed, I will check:

orientation: A&O x 4? (person, place, time, & events prior)

eyes: PEARL? (pupils equal and reactive to light) I don't check for accomodation

EOM (extraocular movement): intact? (CNs III, IV, & VI)

smile: equal?

tongue thrust: drifting to one side?

pronator drift: present?

muscle strength: biceps, triceps, grip, plantar flexion, & dorsal flexion. Rated on the 0-5/5 scale.

ambulation: IF I observe the patient ambulating, then I will document if normal/abnormal

I don't normally check DTRs, clonus, Babinski, etc.

needsmore$

Specializes in emergency nursing-ENPC, CATN, CEN.

I agree with thanatos--usually you get the info you need with a basic neuro exam--usually the docs are obtaining the NIH stroke scale exam to determine TPA appropriateness--

veetach

Specializes in Emergency Room/corrections. Has 16 years experience.

I agree with thanatos--usually you get the info you need with a basic neuro exam--usually the docs are obtaining the NIH stroke scale exam to determine TPA appropriateness--

ditto! :)

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