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June 2010, Volume 40 Number 6 , p 58 - 59


  • Vincent M. Vacca MSN, RN, CCRN


FROM THE MOMENT you walk into a patient's room, you can begin evaluating neurologic status simply by observing and engaging the patient with a quick 60-second exam. By assessing the patient's appearance and verbal and physical responses, you can tell if the patient's neurologic status is unchanged from baseline or if the patient has developed new deficits that require further clinical investigation.Start by observing the patient's level of consciousness (LOC), position, posture, facial symmetry, and respiratory pattern. From these initial observations, you can begin to assess the patient's degree of alertness, attention, and arousal. Awaken a sleeping patient as appropriate to perform the neurologic assessment. Speak at a normal conversational volume (unless the patient has a hearing deficit). Introduce yourself and ask the patient a general question, such as, "How are you feeling?", and listen to the reply. Did the patient: * wake up easily? * hear your introduction

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