neurologic assessment


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neurologic assessment

 
evaluation of the health status of a patient with a nervous system disorder or dysfunction. Purposes of the assessment include establishing a medical diagnosis to guide the physician in prescribing medical and surgical treatments, and a nursing diagnosis to guide the nurse in planning and implementing nursing measures to help the patient cope effectively with daily living activities.

Important parts of the neurologic assessment include a general physical examination and a detailed neurologic examination; these may be conducted by either a physician or a nurse practitioner. A neurologic history must also be obtained, as well as any necessary special neurologic diagnostic studies. The neurologic physical examination involves evaluation of the patient's level of consciousness, mood, orientation, speech, content of thought, and memory; gait while walking and ability to stand quietly with feet together; physical status of the head, neck, and spine as determined by palpation, inspection, and auscultation; function of the cranial nerves; sensory and motor function; and reflex activity.

Nursing assessment of a patient's neurologic status is concerned with identifying functional disabilities that interfere with the person's self-care ability and ability to lead an active life. A functionally oriented nursing assessment includes: (1) consciousness, (2) mentation, (3) motor function, and (4) sensory function. Evaluation of these functions gives the nurse information about the patient's ability to perform everyday activities such as thinking, remembering, seeing, eating, speaking, moving, smelling, feeling, and hearing. Some patients should also be assessed for signs of hallucinations, delusions, delirium, and convulsive seizures.

A patient with an acute and life-threatening alteration in neurologic function is evaluated and monitored in four general areas: (1) level of consciousness, (2) sensory and motor function, (3) pupillary changes and extraocular movements, and (4) vital signs and pattern of respiration. (See also intracranial pressure.) In many institutions a checklist for “neuro checks” is available to the nursing staff to be used as a guide for objective assessment of a patient with an altered level of consciousness such as coma.

neu·ro·log·ic as·sess·ment

(nūr'ō-loj'ik ă-ses'mĕnt)
The appraisal of the nervous system by a health care provider.
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