Physical assessment - Comprehensive: Nursing

A comprehensive assessment provides information on the overall status of a client’s health in addition to providing data about each individual body system. This type of assessment is useful when identifying priorities for client care or evaluating how an illness or condition is affecting the whole person. For example, chronic obstructive pulmonary disease, or COPD, commonly affects the lungs, but can also cause changes to the nails, extremities, and chest wall; so a comprehensive assessment will ensure you can avoid missing important assessment data from other body systems. Now, let’s review the process of completing a comprehensive assessment.

Okay, the supplies you’ll need include a stethoscope, penlight, tongue depressor, an otoscope, drapes, and gloves. Then, prepare for the exam by ensuring your client is in a comfortable position, that your hands and stethoscope are warm, and that the temperature in the room is comfortable. Provide privacy by closing the door and curtains, properly draping your client, and only exposing areas of their body as needed to perform your examination. Before getting started, explain the procedure to your client and be sure to answer any questions they might have before obtaining verbal consent. Then, perform hand hygiene and collect your supplies.

Methods of assessment for the comprehensive assessment include inspection, percussion, palpation, and auscultation.

One of the most important things to remember when performing a comprehensive assessment is to use an organized approach so you don’t accidentally exclude a body system. One way you can organize your assessment is to perform what’s called a head to toe assessment, starting with the head and then systematically moving down the body all the way to the toes. Another technique is to prioritize the assessment of a body system that is potentially related to your client’s symptoms, like assessing the cardiovascular system first for a client with valvular disease, before moving on to the next body system.