Neurological Assessment

[imastudentnurse2013]

i'm making some scripts for a school assessment demo. i've done one for pain assessment using pqrst. i need to do another one for neurological assessment using the glasgow coma scale but i'm stuck to this.

1. wash hand

2. gather equipment

3. introduce self

- hi! my name is (practitioner's name). i'm gonna be your nurse for today.

4. check for right patient/ record and arm band

- your name is (patient's full name)

- is it okay if i call you (patient nickname) great!

- one of the things i'm gonna do right now is check your arm band to check everything matches.

- can you spell your last name for me? ok (check record as well while holding arm band)

- and your date of birth? thank you

5. then say the medical record number and check with the sticker on patient record

6. what we're gonna do right now is assess your _______________

how does a nurse tell a patient that she's doing a neuro assessment without it being akward and weird? how do i fill up this sentence?--- what we're gonna do right now is assess your _______________... is there a better way to do this? please help.

cheers,

imastudentnurse2013

[Esme12, ASN, BSN, RN]

How coordinated you are? How alert you are? ....I'm going to assess your nervous system right now. :)

[Flo., BSN, RN]

I just tell them I am doing a neuro assesment, I am going to ask you some funny questions.

[Dixielee, BSN, RN]

I just tell them I am doing a neuro assesment, I am going to ask you some funny questions.

I usually do something similar. You can get a lot of information just from casual conversation. As far a neuro questions, I do tell them that I know the questions seem silly but it is part of a systematic assessment that we all use to make sure that they are functioning the way they need to. I also tell them a lot of people will be asking them the same or similar questions.

I had a cute little old lady once who was very pleasantly confused. I asked her is she knew were she was. She replied cheerfully, "I sure do!" I asked where and she said, "I'm right here!" And she was right!

[xtxrn, ASN, RN]

I used to tell them I had to ask them some questions that might sound kind of dumb, but there were places on the paperwork that required their answers....most laughed, whether they had a clue or not

[nurseprnRN, BSN, RN]

as time goes by you will learn to integrate a lot of assessment into other things you do. for example, while you bathe someone, you can chat and get a decent sense of level of consciousness/orientation level/dysarthria/hearing, not to mention knowledge base, family and home milieu, and a host of other things. you can say, "can you lift your arm for me/hold the washcloth/ wash your own face?" and see whether there's weakness, unilateral neglect, or ability to follow multistep commands. you will look at peripheral perfusion, skin healing, sensation; you can see whether eyes track together or not; you will see if there's a visual field defect. you will do all this almost automatically, because you know it matters. you'll use your little light to check pupils, and (depending on circumstances) do the cold calorics, sensation levels with the feeler gauges, transcutaneous oxygen levels, or whatever other specialized exams prn, too, in a dedicated time.

right now, you need to get practice in all these things separate from other activities, because they're new to you and you aren't in the place you need to be yet. it's sort of like learning to drive a car-- remember how you couldn't concentrate on the other cars around you if the radio was on, or carry on a conversation in traffic, or work the signal lights smoothly, or parallel park when you were first learning to be behind the wheel? now, after years of it, you can do more of these things not exactly without thinking (because once we stop thinking, we and our patients are in trouble), but automatically and with more mindfulness of how you'll fit them into the big picture.

[imastudentnurse2013]

Thank you for all your responses! You've all been a great help!:redpinkhe:redpinkhe:redpinkhe I was able to move on with the script. Now, our group just needs to video it and upload it on our school portfolios. I wonder how all of you managed to pass all the nursing subjects and all those essays! :bowingpurI'm on my first year. It's a lot of work and I know there's a heaps more coming!:sstrs: But I'm enjoying the course so I think I'll be fine. :anpom:Oh well, THANKS again! Wish me luck for the video!:stdnrsrck: