Focused Assessment by System

Focused assessment is a targeted, system-specific examination performed in response to a patient's chief complaint, change in condition, or abnormal finding during routine monitoring. Unlike a comprehensive head-to-toe assessment, the focused assessment directs clinical attention to the relevant body system. Each system follows a structured approach: inspection, auscultation (always before percussion/palpation for abdomen), percussion, and palpation. The cardiovascular focused assessment includes vital signs, heart sounds (S1, S2, murmurs, S3/S4 gallops), JVD, peripheral pulses, capillary refill, and edema. The respiratory assessment evaluates rate, rhythm, depth, SpO2, work of breathing, adventitious lung sounds, and tracheal position. The neurological assessment uses the Glasgow Coma Scale, pupil reactivity (PERRLA), motor/sensory function, cranial nerve testing, and orientation to person/place/time/situation. The nurse correlates focused findings with baseline status, trending data, and the current treatment plan to determine whether findings represent expected course or clinical deterioration requiring intervention.