Comprehensive Vs. Focused Assessment In Nursing

Comprehensive Vs. Focused Assessment


A patient’s condition is approached holistically in comprehensive health evaluations or Nursing, which also screen for a variety of problems, whereas focused assessments are more constrained and detail-oriented. The thorough evaluations provide a holistic picture of the patient’s health. In addition to concentrated assessments, they ought to be used. Nurses risk missing some significant health trends if focused assessments are the only method of data collection (, 2022). The patient’s deteriorating respiratory status might go unnoticed if a nurse only performs a cardiac assessment. Comprehensive assessments give the healthcare team a clearer picture of the patient’s condition while focused assessments are helpful in providing quick data based on the patient’s specific symptoms.

These evaluations are carried out during admission, at the beginning of a shift, and when evaluating for an illness that is not immediately apparent. The medical staff at a brand-new hospital is not aware of the patient’s current state of health at the time of admission. As the team establishes the patient’s baseline and current status, it is necessary to perform a fresh head-to-toe evaluation. At the beginning of each shift, nurses conduct a head-to-toe assessment to compare the status of their patients to what was noted during the previous shift. This allows for quick treatment and keeps track of patient health trends. Comprehensive or head-to-toe evaluations are extremely in-depth. When the nurse or nurse practitioner examines each of the patient’s body systems, it is known as a head-to-toe assessment. They begin at the patient’s head and proceed down the patient’s body, performing neurologic examinations along the way.

In the way of nursing observations and measurement, Nurses are under the process of training where they need to learn about the way to measure the patient’s symptoms of any disease or check the symptoms reported by them to take proper care and medication. Comprehensive health assessment provides nurses with knowledge of the patient’s physical condition. This makes the consideration thorough the way of various applicable techniques of patient’s physical examination. Here a general survey, patient’s interview or a healthy conversation help to know about their medical history. A patient’s age, weight, height, posture, hygiene and gait, and everything are included in the general survey. Health assessments are used by nurses to gather background information on their patients and to establish a rapport with them that can handle and mitigate the level of anxiety and foster trust. At the time of admission into an effective and adequate care facility or the initial visit to an outpatient centre, a thorough health assessment is typically carried out.

Introduction To Focused Assessment In Nursing

Focused assessments are nursing evaluations that concentrate on the particular bodily system where the patient exhibits a problem, disorder, or concern. This may apply to a single-body system or several. When a patient comes in for a specific problem, you’ll most frequently see these procedures being done in emergency rooms. Instead of performing a thorough medical evaluation to look into every potential factor that might be affecting a person, their aim is to pinpoint and resolve a single problem. A continuous and crucial part of nursing is assessment. To doctors and other healthcare professionals, nurses present their findings. This encourages an interdisciplinary method of providing healthcare in which the patient is treated by a group of specialists. As they spend their time observing and assisting their patients, nurses are frequently seen by the bedside of patients. An evaluation is done by the nurse every time they interact with a patient. In the nursing process, assessments are the cornerstone. Nurses plan patient-centered care in a methodical manner using this process. The nurse’s thorough assessment, during which they gather information about the patient, kicks off the cyclical process. They make nursing diagnoses using this information, along with patient goals and interventions to help them achieve their objectives. To know more students can take help from nursing assignment help experts.

Nurses should use their best clinical judgment to decide which focused assessments apply to their patients. For most patients in the emergency department, as well as for inpatients, the situation is urgent. A thorough evaluation of a particular body system by a nurse is known as a focused assessment. When a patient complains of certain symptoms or has a disease that affects a particular body system, this is typically done. Focused evaluations are helpful in emergencies when there is little time and the patient is displaying severe symptoms. The body system causing the emergency can be the nurse’s main focus rather than unrelated areas. For the patient, this treatment option may be life-saving. As part of a focused assessment, the nurse may also inquire with the patient about their medical background as it relates to a particular body system.

Comprehensive Assessment Examples

As per the analysis made by the National competency standard for the nurses who are registered under the license and there the publication made by the NMBA which Is known as Nursing & Midwifery boad of Australia where the registered nurses are relucted in conduction of the systematic and comprehensive nursing assessment plan and procedure. Through these assessments, registration and license, nurses able to provide best planned nursing care after make an consultation with the Individuals along with the interdisciplinary health care team facilities in response to the effective and unexpected changing scenarios. Extensive nursing assessment that takes into accounts the patient’s general appearance, history, physical examination, and vital symptoms (Casey et al., 2022).

Taking a general example, Janelle has only begun her new shift. She walks into a patient’s room and makes her introduction. Since she is not familiar with the client, she conducts a thorough assessment to establish her nursing treatment strategy. Janelle intends to check her patient for abnormalities from head to toe.

Janelle’s evaluation results are shown in the following steps:

Discovery of Body Systems Vital signs: 120/70, 60, and 98 on room air.No lumps or wounds on the headneuropsychological evaluation equal, round, responsive to light, with intact cranial nerves, and oriented pupilsEars: Present light reflex, no cerumen.Neck: No enlarged thyroid or distended veins.Cardiac: Heartbeat regular rhythm and rate; capillary refill under 2 secondsLungs: Bilaterally throughout, all lungs are clear. There are no pulmonary adventitious sounds.Abdomen: Not avulsed, normal bowel sounds, and a regular bowel pattern.Urogenital: Easily and frequently urinatingStrong pulses that can be felt in all extremities.Extremities: unrestricted, full active range of motionSkin: Typical for ethnicity turgor.

Janelle comes to the conclusion that the patient is healthy. The patient is oriented, according to the neurologic evaluations, and the vital signs are within normal ranges. His cranial nerves are undamaged, which suggests that his brain is operating normally.

Focused Assessment Examples

At the time of referring to LPN/LVN practice, several more states are reluctant to use the expression “assessment,” preferring to refer to the precise duties and responsibilities which are covered by the practice’s opportunity of nursing practice instead. Regardless of terminology, the focused assessment is an assessment of an individual’s current status and the concerning situation at hand, contributing to comprehensive assessment by the RN, continuing to support ongoing data collection, and trying to decide who is required to build knowledge and updated about the information and when to inform. The LPN/LVN assigned to a specific group of patients can perform a focused assessment of the patient’s vital symptoms, heart rate, respiration, etc., and report any signs of deterioration to the RN or other clinical nurse provider so that a thorough assessment can be performed (PracticalNursing, 2022).

Examples are most helpful in understanding focused assessments in nursing. As she checks on one of her patients, Janelle, a nurse, acts as shown in the example below.

As soon as Janelle hears the call light ring, she rushes over to the patient’s room to respond. The night before, the patient fell and hit his head. Despite the fact that he didn’t exhibit any alarming symptoms at the time, he is currently complaining of blurred vision and pain in his right arm. Janelle makes the choice to focus her examination on the patient’s head, neurological function, and right arm. The patient’s head is the first area she examines, and she finds a sizable, tender bruise there. During the neuro tests that follow, she discovers that one pupil is bigger than the other. The patient struggles to maintain balance and has unequal strength on each side. She calls for a healthcare provider because these are unusual findings.

The patient’s arm is the next area she focuses on evaluating. She observes that he is unable to move his arm and leg fully and actively. His attempt to fully lift his arm results in a clicking noise, and he is unable to do so. This information is given to the physician by Janelle. The doctor concludes that the patient dislocated his shoulder in the fall and orders additional tests to confirm this. A significant concussion was another injury he sustained. The quick evaluation by Janelle led to an accurate diagnosis and timely treatment.

Comprehensive vs. Focused Assessment In Nursing

Vital signs, a physical assessment, and a history of the patient are all parts of comprehensive health assessments. When providing preventative care and routine medical visits, this is frequently used. Focused health assessments are more thorough evaluations that are related to an ongoing medical condition or a patient complaint. A focused assessment aims to address a specific issue that could have an impact on one or more physiological systems. Which focused assessment component is more appropriate for your patient at this time will be decided using relevant clinical judgement. For instance, as an ICU nurse, your focused evaluations are typically focused on a single body system, such as the cardiac or respiratory systems. On stable patients, the focused assessment is frequently conducted as well. For instance, this kind of assessment is more typical in a secure environment. This is used whenever a patient has a complaint or condition. The key difference between focused care and comprehensive care is that the latter has a specific goal. In varying degrees, both of these nursing evaluations involve a full body check-up as well as some type of patient interview to determine mental status. According to Nursing dissertation help experts the patient’s needs and the knowledge gained from the initial head-to-toe assessment determine the extent and depth of the assessment that is carried out by the on-duty nurse. 

Among the two nursing assessments discussed in this blog, comprehensive nursing assessment for the RN consists of a more thorough collection of data, information and  for not only patients but also their friends and families where  the communities also engaged in getting this opportunity. (Reinhard, 2022). The RN is in charge of anticipating changes in conditions, exigent changes in a patient’s health status, as well as any changes to previously existing conditions. A thorough assessment also considers the effectiveness of all nursing care, the implementation of nursing interventions, diagnoses where the necessity of any modifications to those interventions. Organizations may decide to staff only RNs in certain units or departments that have patients who require frequent interventions, or they may make a decision to only give stable patients to LPNs or LVNs in those departments or units. An LPN/LVN may be utilised by outpatient department, such as a Specialist’s clinic, to allow patients liposuction details that has been created by RNs. LPNs, or licenced practical/vocational nurses, can work in a variety of nursing positions. Any organisation can benefit from the professional depth and breadth of care that an experienced LPN/VN-led care team can offer (Nursing health-assessment, 2021). To address the RN labour shortage and provide patients with the most possible competent and  safe care that is completely within the LPN/NV scope of practise, effective use of these nurses is crucial. Given the differences between these two assessments in nursing, a nurse would ensure that the patient remained relatively stable overall while performing a focused assessment to preclude them from being excessively pre – occupied with that one facet of the test. For instance, if a patient first keeps complaining of visual fatigue before reporting breathlessness, the nurse should continue with the eye examination and any necessary eye interventions without pausing before addressing the breathing issues. Adjust as necessary as the clinical picture evolves.

Areas Nurses Need To Consider Under The Comprehensive Nursing Assessment

It can be challenging for nurses to identify a patient’s medical needs without conducting a thorough assessment. Informing nurses of a problem is insufficient for patients. A course of action must instead be chosen by the registered nurses on the basis of the measurement and analysis they make during physical examinations. The ability to communicate with patients and assist them in taking actions to manage their health is a skill that nurses have developed through the completion of systematic and effective assessments. A nurse’s fundamental nursing assessment skills are built upon by this worrying curriculum. After receiving their BSN, nurses are equipped to conduct thorough health assessments and use their knowledge to reach reliable clinical conclusions (EIU online, 2022).

In the viewpoint of assignment help experts, a thorough evaluation starts with a patient’s medical history being recorded before beginning a physical examination. According to AMN Healthcare Education Services, the patient’s medical complaint, current health status, prior medical history, current lifestyle, psychosocial status, and family history are all included in the health history (Nursing Management, 2017). The history of the concerning patient’s health and other relevant information, past estimation gives nurses detailed knowledge of symptoms, childhood illnesses, associated medical experiences, and potential for certain diseases. An examination of the patient’s body systems is performed after the health history information has been logged.

An evaluation of everything from head to toe includes the following:

  • Skin
  • Neurologic activity
  • nose, throat, eyes, and ears
  • respiratory process
  • respiratory and cardiac systems
  • Abdomen
  • both joints and muscles
  • Body parts: limbs, shoulders, hips, ankles, and feet
  • system of reproduction
  • Nutrition
Source : (Wayne,  2022)

Areas Nurses Need To Consider Under Focused Nursing Assessment

Focused assessments are conducted by healthcare professionals in response to specific health problems of the individual patient which the assessor determines requires additional examination of one or more body systems. From the various analysis reports, blogs, and articles it has been observed that Focused respiratory system assessment generally consists of questioning and considering an interview, a conversation where the patient who has any signs of serious health issues as well as symptoms of pulmonary diseases, such as shortness of breath, coughing as well as gathering subjective information about the patient’s history of smoking, gathering information about the patient’s and their family’s medical history of pulmonary disease (Doyle, and McCutcheon, 2015). Also evaluated are objective data.

Source: (Doyle, and McCutcheon, 2015)

Checklist that is part of the focused assessment includes:

  • Concerns for safety
  • Wash your hands.
  • For contact precautions, check the room
  • Tell the patient who you are.
  • Using two patient identifiers, confirm the patient’s identity.
  • To the patient: Describe the procedure.
  • In your evaluation, be logical and methodical.
  • Utilize effective techniques for questioning and listening.

Steps under Focused assessment include,

  • Ask specific questions about smoking, environmental exposures, and a person’s history of respiratory illness.
  • Ask pertinent questions about chest pain when breathing, previous medical history, fever, chills, and coughing up sputum. Medication and therapy as needed


  • Check patient’s frequency to breathe and use the auxiliary muscles the chest’s design and symmetry
  • Rate, depth, and rhythm of breathing for one minute
  • Lips, face, hands and feet are all skin tones.
  • Check whether O2 saturation is at accurate level 
  • Check the lungs’ (posterior and anterior) auscultation for breathing noises and other unexpected sounds.
  • Documentation of the assessment outcomes and associated health issues in accordance with agency policy.

Summing up

End up making sure the data collected is accurate, complete, and properly documented during the assessment’s evaluation phase. In the previous analysis and discussion, we have understood about the clinical responses and judgments including the questioning about health issues and past history taken into consideration for providing the health care and planning the best care and medication for the patient. Here the nurses after completing the nursing assessment become ready and prepared to apply their knowledge, critical thinking, and solving capabilities. The registered nurses are appointed in the institute with the duty and responsibility to ensure they able to provide the appropriate care and support to the patients considering the abnormal outcomes. To know more students can take help from coursework help experts online.

This might entail informing the medical team, and shift-leading, pertinent allied health team ANUM of the findings. While under RCH care, patients should have regular assessments to check for changes in their conditions. Regular documentation of these assessments should also be done. The primary duty of a nurse is to perform patient health assessments irrespective of the type or form of the assessment. They track status change and goal progression and are an essential part of every care plan.

The full medical history of the patient is gathered, along with a physical examination, during a comprehensive assessment by a nurse. This kind of evaluation is typically carried out at the time when the patient is admitted to a hospital or long-term care facility, or for first-time patient visits at doctor’s offices and outpatient clinics. Comprehensive holistic health assessments are becoming a more popular approach in holistic comprehensive assessment patient-cantered care across the lifespan. It combines techniques for general assessment with a thorough analysis of the patient’s overall, lifelong risk profile and the impact of cultural, sociological, and familial characteristics. Contrarily, it must be understood that in focused assessment nursing, nurses may also carry out a problem-focused assessment to delve deeper into the issue. This is only used after a thorough evaluation has been completed and a baseline established. It is beneficial when a patient experiences a change in status or a new symptom.


Nursing assessment . Alamy. Available at: [Accessed September 30, 2022]. 

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Reinhard, S. et al., 2022. Health improves when Nurses Know Health policy. Blog.

practical nursing, 2022. Focused vs. comprehensive assessment.

Wayne, G., 2022. The nursing process: A comprehensive guide. Nurseslabs.

EIU online, 2022. What is a comprehensive health assessment? – EIU online. Eastern Illinois University.

Nursing Management, 2017. Healthcare staff urged to contribute to ‘radical overhaul of nursing education.’ Nursing Management, 24(5), pp.7–7. 

Doyle, G.R. and McCutcheon, J.A., 2015. 2.7 focused assessments. Clinical Procedures for Safer Patient Care.

Nursing health assessment, 2021. Importance of Health Assessment Skills for Nurses. Lamar University Online.

Reinhard, S., 2022. Health improves when Nurses Know Health policy. Blog.

Kleber, K. and Prorok, M., 2022. Types of nursing assessments every nurse needs to know. FRESHRN.

Casey, M., Cooney, A., O’Connell, R., Hegarty, J.M., Brady, A.M., O’Reilly, P., Kennedy, C., Heffernan, E., Fealy, G., McNamara, M. and O’Connor, L., 2017. Protection Status
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