Kim Maryniak, PhD, RNC-NIC, NEA-BC
The fundamental processes of the brain and nervous system are the key to understanding why nurses perform a focused neurological assessment. If there is a disruption to any of these processes, the whole body suffers. The neurological history and exam allows the examiner to pinpoint various areas of the brain or nervous system that may be dysfunctional.
Specific signs and symptoms manifested by your patient are associated with specific areas of the brain. Nurses observe for signs and symptoms that may be abnormal and link them to general areas of the nervous system that may be causing the disturbance. Nurses must also recognize when further neurological injury is manifesting, intervene appropriately, and notify the physician for a change in plans for the patient.
Components of the neurological history should be integrated with the steps taken during the complete physical examination. It may not be necessary to perform the entire neurological exam on a patient with no suspicion of neurological disorders. Nurses should perform a complete, baseline neurological examination on any patient that has verbalized neurological concerns in their history. The neurological exam should be rechecked at periodic intervals with any patient that has a neurological deficit (Jarvis, 2016; Wilson & Giddens, 2017).
History of the patient requires questions about injury, neurological or mental health disorders, deficits, headaches, syncope, and vertigo. Speech, swallowing, and coordination should also be assessed. Inquiry about exposure to environmental hazards is also a consideration. Important components of the neurological examination include assessment of mental status and testing cranial nerves (Jarvis, 2016; Malik, 2017).
A neurological assessment is a vital component of patient assessment. For more information about the neurological system, refer to the RN.com course Focused Neurological Assessment.
Jarvis, C. (2016). Physical examination and health assessment (7th ed.). St. Louis, MO: W.B. Saunders.
Malik, A. (2017). Neuropsychological evaluation. Retrieved from: http://emedicine.medscape.com/article/317596-overview
Wilson, S. & Giddens, J. (2017). Health assessment for nursing practice (6th ed.). St. Louis, MO: Elsevier.
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