HEALTH ASSESSMENT VIDEO CHECKLIST

PATIENT NAME

DATE OF BIRTH

Does patient appear to be their stated

age?

Today’s Date

WHERE ARE YOU

LEVEL OF CONSCIOUSNESS By asking patient name, DOB & today's date,& where they

are I am determining they are

ALERT AND ORIENTED TO PERSON, PLACE & TIME

By asking him these few questions I am also LOOKING AT HIS

APPEARING & ASSESSING:

NUTRITIONAL STATUS



WELL DEVELOPED/ POOR

POSTURE & POSITION



UPRIGHT / POOR POSTURE

PHYSICAL DEFORMITIES / MOBILITY WHETHER OR NOT I SEE ANY OBVIOUS PHYSICAL

DEFORMITIES OR OBVIOUS MOBILITY LIMITATIONS

FACIAL EXPRESSION APPROPRIATE OR NOT APPROPRIATE FOR THE SITUATION

MOOD & AFFECT



FLAT / APPROPRIATE / HEIGHTENED

SPEECH



CLEAR OR NOT



APPROPRIATE OR NOT

HEARING



DIFFICULTIES OR NOT

PERSONAL HYGIENE



CLEAN / DIRTY



KEMPT / UN-KEMPT

HEIGHT

WEIGHT

BMI I WILL CALCULATE BMI BY CONVERTING WT IN LBS TO KG (WT

DIVIDED BY 2.2) & CONVERT HEIGHT IN INCHES TO METERS.

FORMULA IS THEN WEIGHT IN KG/HEIGHT IN METERS SQUARED

MEASUREMENTS AND VITAL SIGNS

I AM GOING TO TAKE YOUR PULSE & YOUR RESPIRATIONS

FOR 30 SECONDS EACH. I WOULD CALCULATE THESE BY

MULTIPLYING X 2

RADIAL PULSE:



REGULAR / IRREGULAR

RESPIRATIONS:



SHALLOW /DEEP



LABORED/ UNLABORED

BLOOD PRESSURE I AM GOING TO USE A TOWEL AS A PROP TO TAKE THE

BLOOD PRESSURE, BUT I WOULD NORMALLY USE A B/P

CUFF & PUMP THE BULP & THEN RELEASE, CHECKING THE

GAUGE FOR THE SYSTOLIC & DIASTOLIC #S

Health Assessment Video Checklist

Comprehensive Health Assessment for Patients and Populations (C350)

Western Governors University

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