Performing a good head-to-toe assessment.

[RedXIII_]

Hi everyone! I'm a nursing student and I was wondering if any of you could give me some good examples of a well-done head-to-toe assessment. I feel like I jump around too much when I practice. I don't want my patient to sit, lay down, sit, lay down...and yeah you get what I mean. A good example would be nice :) Thanks!

[kmmRN,BSN]

Head-to-toe: start at the top and work your way down; makes doing your assessment quick and easy. :)

[Need2Care]

Yes, exactly, I agree. Start from the top and work your way down and around.

[simboka]

That can also depend on the context of your exam. A school exam is not going to be done the same way as an inpatient. You've got time to develop your practice, and it'll take time before it's smooth.

But literally, "head-to-toe", is a good philosophy. Another way is to sort by system, eg neuro, cardio, pulm, gi, gu... And then also consider what you need to check per position too.

[traumaRUs, MSN, APRN]

Moving to nursing student assistance forum.

[IaCountryGirl]

It's easiest to think of head, shoulders knees and toes.....while you're not really checking shoulders, it should remind you that you start at the head and go downward. The confusing part can be neuro, which is done after the extremities...but honestly, if it's easier to add it in with the face, then by all means do so.

[RedXIII_]

Thanks everyone!

[kmmRN,BSN]

I also try to ask general questions first, checking orientation, pain assessment, nausea, etc. It helps me to know where to focus my assessment, and then if I forget anything, I will ask at the end of the assessment

[canigraduate]

Another way to do it, that one of my clinical instructors taught me, is to do interview, then front from top down, then back from top down (if the patient is immobile for whatever reason).

[JROregon, ASN, BSN, RN]

I'm working on typing up my script. I won't be able to take it in with me while I get tested but it helps me remember what to do. I'm starting with the A&Ox3, eyes, nose, mouth (checking cranial nerves at the same time), ears/hearing, respiratory, cardo (patient will be sitting on bed)....... Have pt lay down for the gastrointest, passive ROM..... Sit up again to show strength in upper extremities and ankles, check reflexes.... Stand up, strength test knees, check back for scoliosis, heel-toe walk, normal gait, Romberg.... put your skin temp, grips, capillary refill where ever it makes sense. Some people are grouping by neuro, musculoskeletal, cardio and such but I'm trying to organize it in a way that makes sense to me and the pt.

[janets1]

If you are looking for a model of how to (and not to) check you tube. They have several videos. Our instructor requires us to do all stethoscope work at the same time. She finds it inefficient for both pt and student to put on ears multiple times during the assessment.