Comprehensive Head-To-Toe Assessment: A Case Study

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The patient is a 83 years old Caucasian female with a diagnosis of Generalized Weakness and Altered Mental Status. The patient is from home and lives with her daughter. She has a history of hypertension, arthritis, congestive heart failure, nstemi, and atrial fibrillation. First, I will obtain information from the patient’s daughter and collect data about the patient’s baseline and health history. Touhy & Jett (2012) mentioned the importance of assessing the physical, functional, social, and mental status in health and illness, which allows for comparison of patient’s baseline and adjustment of nursing care plan (p. 106). My plan is to do a comprehensive head-to-toe assessment, EKG, blood works, obtain specimen for ua/cs, and diagnostic

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