By assessing the patient's appearance and verbal and physical responses, you can obtain important information about the patient's neurologic status, including:
Is it unchanged/changed from baseline?
Has the patient developed changes that may indicate a problem with the nervous system?
Are there symptoms that need further investigation?
This basic examination can be used during every patient encounter. Refer to Chapter 3 for details related to other components of a neurologic assessment.
Assess ability to speak at normal conversational volume.
Identify external forces (e.g., medications, other injuries, or altered laboratory values) that may affect the patient's responses during the assessment.
Identify abnormalities that existed before the patient's current health problem.
Does the patient:
Wake up easily?
Hear introduction and question?
Open both eyes and keep them open?
Pay attention to you and remain awake and alert?
Demonstrate behavior appropriate for situation?
Track you with head and eye movements as you move around room?
Speak clearly?
Provide appropriate responses?
Demonstrate symmetry of movement in extremities?
Alertness, attention, arousal: Assesses reticular activating system, hypothalamus, and thalamus
Interpretation of what is heard and responds appropriately: Assesses cerebral cortex
Motor function: Assesses corticospinal motor pathway and basal ganglia system
Clear, organized, and appropriate speech: Assesses motor speech and language centers in left cerebral hemisphere
Source: Adapted from Henley Haugh, K. (2015). Head-to-toe: Organizing your baseline patient physical assessment. Nursing, 45(12), 58-61; Hickey, J. V., & Strayer, A. L. (Eds.). (2020). The clinical practice of neurological and neurosurgical nursing (8th ed.). Wolters Kluwer; McCallum, C., & Leonard, M. (2013). The connection between neurosciences and dialysis: A quick neurological assessment for hemodialysis nurses. CANNT Journal, 23(3), 20-26.