neurologic assessment

neurologic assessment

[-loj′ik]

Etymology: Gk, neuron + logos, science; L, icus, like, adsidere, to approximate

an evaluation of the patient's neurologic status and symptoms.

method If alert and oriented, the patient is asked about instances of weakness, numbness, headaches, pain, tremors, nervousness, irritability, or drowsiness. Information is elicited regarding loss of memory, periods of confusion, hallucinations, and episodes of loss of consciousness. The patient's general appearance, facial expression, attention span, responses to verbal and painful stimuli, emotional status, coordination, balance, cognition, and ability to follow commands are noted. Assessment of cranial nerves and deep tendon reflexes is included. If the patient is disoriented, stuporous, or comatose, demonstrated signs of these states are recorded. Observations are made of skin color and temperature; pupillary size, equality, dilation, and reactions to light; respiratory rate, rhythm, and quality; and chest movements and breath sounds. The pulse is checked; ears and nose are examined for possible drainage; strength of the handgrip is tested; and the extremities' sensations and voluntary and involuntary motions are assessed. Urinary output is determined for evidence of polyuria, and the patient's speech is evaluated for signs of slurring and aphasia. Included in the record are concurrent diseases such as hypertension, cancer, and coarctation of the aorta; past illnesses associated with head trauma; seizures; motor, sensory, or emotional disturbances; loss of consciousness; and neurologic, medical, or surgical procedures. Pertinent to the assessment are the patient's sleep pattern; medication; personality changes; relationships with family and friends; and a family history of seizures, stroke, mental illness, tumors, or sudden death. Diagnostic aids that may be required for a complete evaluation include a lumbar puncture, complete blood count, myelogram, magnetic resonance imaging, echoencephalogram, brain scan, computerized tomogram, and determinations of glucose, fluid, and electrolyte levels.

interventions The nurse may conduct the interview to obtain subjective data, examines the patient, and assembles the pertinent background information and results of the diagnostic tests.

outcome criteria A careful neurologic assessment is an important aid to the neurologist in establishing a diagnosis and the course of treatment.