Data Collection

Head to Toe Assessment

Vital Signs:

  • Any signs of distress indicating a patient emergency
  • Patient's level of consciousness, speech, orientation

 

Eyes:

  • Pupil size response to light
  • Extracurricular eye movements
  • Accommodation

 

Mouth:

  • Skin color around lips and tip of nose (checking for circumoral cyanosis)
  • Mucous membranes for moisture (area between gums and cheek will stay moist even with a mouth breather unless patient is dehydrated)