30
skill 2-8
Undertaking a neurological examination
(continued)
Comments
Excellent
Satisfactory
Needs practice
Copyright © 2014 by Wolters Kluwer Health | Lippincott Williams & Wilkins.
Checklists for Clinical Nursing Skills by Louise Sparkes, Jennifer Bassett and Elisabeth Jacob.
(h) Evaluate the patient’s ability to understand the spoken
and written word.
14. Test cranial nerve (CN) function.
(a) Ask the patient to close their eyes, occlude one nostril
and then identify the smell of different substances,
such as coffee, chocolate and alcohol. Repeat with the
other nostril.
(b) Test visual acuity and pupillary constriction.
(c) Move the patient’s eyes through the six cardinal
positions of gaze.
(d) Ask the patient to smile, frown, wrinkle their
forehead and puff out their cheeks.
(e) Test hearing.
(f) Before testing the gag reflex, explain to the patient
what you are about to do, and that this may be
uncomfortable. Test the gag reflex by touching the
posterior pharynx with the tongue depressor.
(g) Place your hands on the patient’s shoulders while
they shrug against resistance. Then place your hand
on the patient’s left cheek and have the patient push
against it. Repeat for the right cheek.
(h) Test the face and neck for pain sensation, light touch
and temperature.
15. Assess the patient’s deep tendon reflexes (DTR).
(a) Place your fingers above the patient’s wrist and tap
with a tendon hammer; repeat on the other arm.
(b) Place your fingers at the elbow area with your thumb
over the antecubital area and tap with a tendon
hammer; repeat on the other side.
(c) Place your fingers over the triceps tendon area and
tap with a tendon hammer; repeat on the other side.
(d) Tap just below the patella with a tendon hammer;
repeat on the other side.
(e) Tap over the Achilles’ tendon area with a tendon
hammer; repeat on the other side.
16. Ask the patient to close their eyes. Using your finger or
an applicator, trace a one-digit number on the patient’s
palm and ask them to identify the number. Repeat on the
patient’s other hand with a different number.
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