From Head to Toe

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Gently palpate nose for any tenderness. Make sure nose is in midline and symmetrical. Excessive flaring of the nostrils may indicate respiratory distress.

Have patient close one nostril with fingertip and breathe in and out through that nostril. Repeat with other nostril. If patient cannot exhale through each naris, the nasal passage is occluded. Here’s our in-depth guide to conducting a head-to-toe assessment, complete with explanations and linked videos. We’ll start with some general principles to keep in mind throughout the assessment and then move on to a more detailed look at each of the tasks you’ll need to complete for each area/system of the body. This head-to-toe nursing assessment video is useful because it presents the assessment in a realistic-seeming care setting with a patient who asks questions. It also shows the nurse asking questions about the patient’s life quality, and closely explaining every step of the assessment so that the patient knows what’s happening. Encourage students’ creativity by having them ideas for other animals that could have been in the story (cat, dog, fish, tortoise, mouse..), and then have them demonstrate how those animals move. We went to Maximum Sound Studios in the Old Kent Road and started recording in the late afternoon. Things didn’t seem to be going too well recording-wise, although the boys spent about four hours routining.Assess patient teeth for number (28 in children, 32 in adults), color, and alignment. Note any cavities or chips. Assess gums for bleeding, puffiness, or retraction (the pulling of the gum away from the tooth, which can give teeth an “elongated” appearance). Also note presence of halitosis; gum disease and oral infection are some of the most common causes of bad breath. Patient uvula should be in the midline, pink or reddish in color, and free of swelling or lesions. When the patients says “ah,” uvula should move forward and up. (This tests cranial nerve X.) Ask one student to mime being an animal (maybe from a flashcard prompt) and when the other students have guessed what animal it is ask them why they could identify it, e.g. “She waved her long nose” for an elephant.

We adore Eric Carle books in our house. One favorite that we have been loving for quite a few years now is From Head to Toe. There are a few things that I love about this book. I love all of the animals, and I love that it encourages movement and interaction. I like it when a book makes a child want to get up and go! Since I love that aspect of the book, I decided to use that to create a fun activity to go along with the book From Head to Toe. I made a set of printable From Head to Toe Activity Cards. (See more of my book activities for kids!) Did you like that? Was it fun? What was the best bit?”/ “Did you like the drawings? Would you like to make a drawing like that?” Verify that eyes are symmetrical, that the palpebral fissures are equal and there is no ptosis. Have patient blink; make sure that eyes close completely If you’re looking for more examples, you can find lots of example videos of student assessments on Youtube (just type in “head-to-toe assessment nursing”). However, be aware that every student is going off of a different professor’s rubric, and not everything may be 100% correct! Have patient demonstrate range of motion in arms and hands. They should be able to roll shoulders, show flexion and extension of the elbow joint, circle the hands around the wrist joint, and demonstrate full flexion and extension of the wrist without pain. Also have patient squeeze push against your hands, pull your hands towards them, and squeeze your fingers to assess strength, which should be equal bilaterally. Here’s a video showing this process.You should test range of motion of the lower extremities with the patient lying down. Patient should be able to flex and extend the ankle joint, and circle the foot. Patient should also be able to bend the knee and then move leg outward (to test hip ROM) on each side. There should be no pain. For the Rinne test, strike the tuning fork and place the base against the mastoid process. Start a stopwatch. Tell the patient to tell you when they stop hearing the sound of the tuning fork. When they stop hearing the sound, move the tuning fork so the forks are in front of the ear (and note the time on your stopwatch). Tell them to tell you when they stop hearing the sound again. Patient should hear the sound of the tuning fork through the air (in front of the air) 2x longer than through the bone. Repeat on the other ear. You can assess the conjunctiva by gently applying downward pressure to the skin below the patient’s eyes. Conjunctiva should be pinkish and free of lesions. Unusually pale conjunctiva can be a sign of anemia, and inflammation or infection can cause red conjunctiva.