*NURSING > Final Exam Review > Head_to_Toe_Assessment_Script.docx (All)

Head_to_Toe_Assessment_Script.docx

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Chamberlain University Me: Okay, do you know what year it is? Patient 2019 Me: And do you know who our current president is? Patient: Donald Trump Me: Patient is alert and oriented (x4) Spe... ech is clear and clothing is appropriate to time and place. General Appearance Me: Okay, we’re gonna go ahead and move on to your general appearance. look at the patient  Posture is erect.  Skin is appropriate to age.  Skin color is appropriate to ethnicity.  No signs of acute distress.  Nutrition is adequate.  Mood and behavior are appropriate to situation.  And clothing is appropriate to situation as well.  (No visible devices or equipment being used.) Vital Signs Me: I will now be taking your vital signs. check temperature before checking the temp, ask if patient had anything hot or cold to drink, or smoked in the last 30 mins check the pulse oximetry take the blood pressure ask if patient knows their usual blood pressure measurement check respirations count for 30 seconds and multiple by 2 Skin & Nails Me: I’m gonna go ahead and start with your skin. Skin color is appropriate to ethnicity. There are no signs of lesions, incisions, wounds, rashes, and no tattoos visible. I’m gonna go ahead and check for your temperature. palpate skin using the back of the hand [Show More]

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