How do I do a neuro check?

This topic contains 2 replies, has 3 voices, and was last updated by Krista Krista 1 year, 6 months ago.

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  • #69795 Reply


    I’m a nursing student and I have a question about neuro checks. in my 2nd semester. I’m starting my clinicals next week and will be on my neuro rotation. I would like help and tips on how to do a neuro check on a patient before I begin the rotation. I also would like to know if there are any tips for nursing students from seasoned nurses on here, specifically for neuro rotations.

    How do I do a neuro check


  • #69797 Reply

    Michellie Jones

    I would imagine that your instructor would provide you with guidelines on how to do this so I wouldn’t sweat it too much.

    Just remember your assessment skills that you should have learned in 1st semester.

    Are the pupils equally round and reactive to light and accommodation. (PERRLA)
    Can the patient speak and follow commands
    Have them grasp their fists around your finger bilaterally and check for strength.
    If they are alert and oriented can they push their feet on your hands?

    Can they respond appropriately to questions

    Good luck. Ask your instructor what she expects during the assessment. They’re all very different in what they expect.

  • #69799 Reply

    I do neuro checks on all my patients frequently, even if it’s not required. You don’t know when a patient’s mental status could change and you may not be aware, if you don’t check them.

    At the beginning of the shift I always do a thorough neuro check so I will have a good baseline in case things change.

    Are they AAOX3 (alert and orientated) to person, place and time.

    Ask their name, ask them if they know where they are and also ask them what date it is.

    At the beginning of the assessment give them three words that are unrelated, such as: apple, plane and house. Tell them to remember the words and then at the end of the assessment ask them what those words were.

    Look at PERRLA, are their pupils equally round and reactive to light and accommodation. Look to see if the pupils react appropriately bilaterally. Make sure one pupil is larger than the other.

    Do they have any c/o a headache, any numbness or tingling any where

    How is their vision? Is it blurred or do they have double vision? then i ask if they have a

    Ask them to smile to see if their mouth is equal and symmetrical on both side and one side isn’t drooping

    I alsi ask them to stick their tongue out and I check for symmetry.

    Make sure that you check their pupils with a light and document the size of the pupil in millimeters.

    I also ask them to watch my finger as it moves in to touch their nose and go from side to side and ask them to follow with their eyes.

    I check their grip by allowing them to squeeze both your hands simultaneously.


    Ask them to push down on your hands with their feet. then “push on the gas” the foot on my hand. and then put my hand on their toes and ask them to bring their “toes to their nose”

    then put your hands on top of their feet and have them push their feet upward.


    And that’s about it. You can also check their extremities one by one, by lightly touching them and having them tell you when they feel it and what it feels like. thats the basic neuro check. if there is any change

    Good luck and I hope this helps! I hated being in nursing school lol

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