Nursing Skills Lab (Head To Toe Physical Assessment Checklist) – Flashcards

17 test answers

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