Nursing Skills Lab (Head To Toe Physical Assessment Checklist) – Flashcards
Unlock all answers in this set
Unlock answersquestion
Vital Signs (4)
answer
State "vital signs obtained" Ask regarding pain Height Weight
question
Neurological (3)
answer
Alert to person Alert to place Alert to time
question
Head (5) Inspection/palpation
answer
Shape/symmetry Lice Lumps Mass Assess carotid
question
Ears (4) Inspection/palpation
answer
Wax Discharge Lesions Pain
question
Nares (3) Inspection
answer
Sores Deviation Drainage
question
Pupils (4) Inspection
answer
Pupils equal Round Reactive to light Accommodation
question
Mouth/mucous membranes (3) Inspection
answer
Moist Pink Smooth
question
Apical pulse (2) Auscultation
answer
Assess carotid rate Regular or irregular
question
Breath sounds (2) Auscultation
answer
Anterior/posterior (upper, middle, lower) (inhale/exhale) Ask regarding productive cough (sputum)
question
Upper extremities (6) Inspection/palpation
answer
Skin color Skin temp Turgor (chest) Radial pulses Capillary refill Handgrip and strength
question
Abdomen (look, listen, then feel) (4) Inspection/auscultation/palpation
answer
Soft and round Distended or non-distended Tender or non-tender RLQ->RUQ->LUQ->LLQ
question
Elimination (bowel) (6) Aucultation
answer
Auscultate Ask last BM Ask about continence or incontinence Color Consistency Amount
question
Bladder (4) Palpation
answer
Palpate for retention Ask last void Ask about voiding freely Ask about color/clarity
question
Lower extremities (4) Inspection/palpation
answer
Skin color Skin temp Pedal pulses x 2 (DP & PT) Capillary refill
question
Skin (4) Inspection/palpation
answer
Lesions Ulcers Temperature Discoloration
question
Musculoskeletal (1)
answer
Assess back/spine for curvature
question
Safety (5)
answer
Pt in bed Low position Side rails up Call light in reach Special equipment within reach
