Objective Assessment Flashcards
In what order should you conduct an objective assessment
- general observations
- alertness
- cognition/ orientation
- memory
- vision
- hearing
- speech
- sensation
- range of movement
- muscle tone & power
- mobility
- funcitonal Ax
- balance
how can you assess alertness of a patient
using GCS score or AVPU
how can you assess cognition/orientation of a patient
use your initiative to see whether they are orientated to person, place, time and situation etc.
how can you assess the memory of a petient
see if their memory is:
- Immediate
- Recent
- Remote
- Verbal
- Visual
how can you assess the vision of a patient
- can patient track finger
- check periferal vision at eye level and from below with each eye
- has their sight changed since their latest epsiode etc.
- any diplopia?
- blurred?
- if any abnormalities refer on to specialist
how can you assess the hearing of a patient
- do they have a hearing aid
- can they audibly hear your
ho can you assess the speech of a patient
- see if they have dysphasia (receptive - wernicke’s area/ expressive - Broca’s area)
- dysarthria? form having weak muscles
how can you assess sensation of a patient
- ability to detect touch using cotton whool ball for soft touch or a neurotip for blunt or sharp
- pain - using neurotips
- vibtration using the vibrating tongues and patient should be able to differentiate when the vibrations end
- temperature can be tested using two tubes, one with cold and one with hot water and see if patient can differentiate
- one and 2 point discrimination : paper clip, two point discriminator, or calipers and apply pressure at certain points
- proprioception: wiggle thumbs or toes ith patients eyes closed, ask them if it is up or down without looking. OR touch nose to your finger
how can you assess patients range of moevement and power
- start by seeing if patient can demonstrate active range of movement?
- if so then they are automatically a 3 on oxford scale, but provie resistance through range and see if they can move against you
- if not then facilitate the limb to counteract gravity. do they have any signs of activty?
what are the stages of the oxford scale
0 - no contraction
1 - visible/ palpable muscle contraction but no movement
2 - movemnt with gravity eliminated
3 - movement against gravity only
4 - movement against gravity with some resistance
5 - movement against gravity with full resistance
how do you assess muscle tone
use the modified ashworth scale with passive range of movement with variable speed applied to the action
stages of modifies ashworth scale
0 - no increase in muscle tone
1 - slight increase in muscle tone, with a catch and release or minimal resistance at the end of the range of motion when affected part is moved in flexion or extension
1+ - slight increase in muscle tone, manifested as a catch, followed by minimal rsistance through the remainder of the range of motion
2 - a marked increase in muscle tone throughout most of the range of motion, but affected parts are still easily moved
3 - considerable increase in tone, passive moevement difficult
4 - affected parts rigid in flexion or extension
how can you assess a patients movement and function in lying to sitting
- ability ro process the task
- ability to perform the task independently
- movement analysis
how can you assess a patients moveemnt and function in sitting balance
- static posture
- posture/ alignment
- dynamic balance
- movement outside base of support
- consideration of seating
how can you assess a patients moveemnt and function in sit to stand
- ability to process the task
- ability to perform the task independently
- movement analysis
- consideration of equipment
