PHYSCIAL ASSESSMENT
NAME: .
DATE: ..
AGE:
WARD: ..
GENERAL APPEARANCE
SKIN
HAIR
SCALP CONDITION
BRUISES Yes/ No
LUMPS Yes/ No
BLEEDING Yes/ No
TENDERNESS Yes/ No
FACE
EYES
OTHER/ COMMENTS:
.
PUPILLARY REACTION
COMMENTS:
NOSE
SYMMETRICAL Yes/ No
FLARING Yes/ No
PATENCY Yes/ No
MUCOUS MEMBRANE Pink/ Pale
DISCHARGE Yes/ No Amount:.. Colour:
.
MOUTH
MOISTURE Yes/ No
SWALLOWING REFLEX Yes/ No
TONGUE Clean/ Coated
TEETH Clean/ Caries/ Dentures
ODOUR Pleasant/ Unpleasant
GUMS Healthy/ Unhealthy
COMENTS: .
Revised March, 2013
NECK
SWELLING Yes/ No
STIFFNESS Yes/ No
ENLARGED Yes/ No
RANGE OF MOTION Satisfactory/ Unsatisfactory
EARS
THORAX/ LUNGS
BREAST
COMMENTS:
ABDOMEN INSPECTION
AUSCULTATION
PALPATION
TENDERNESS Yes/ No
MASSES Yes/ No
RECTUM
HEMORRHOIDS Yes/ No
RASH Yes/ No
MASSES Yes/ No
NEUROLOGICAL
PAIN Yes/ No
RESPONSE TO LIGHT Touch Good/ Poor
MUSCLE TONE Good/ Poor
MOVEMENT OF LIMBS Yes/ No
SLURRING OF SPEECH Yes/ No
MUSCULOSKELETAL
DATE: .
SIGNATURE: