ICU Nursing Assessment Checklist
Patient Information
| Patient Name |
|
ID/Room No. |
|
| Date |
|
Time |
|
General Appearance
| Consciousness Level (GCS) |
|
Orientation |
|
| Skin Color |
|
Temperature |
|
Vital Signs
| Blood Pressure |
|
Heart Rate |
|
| Respiratory Rate |
|
Oxygen Saturation (%) |
|
| Temperature (°C) |
|
Pain Score |
|
Respiratory Assessment
| Airway |
|
Breath Sounds |
|
| Oxygen Therapy |
|
Mechanical Ventilation |
|
Cardiovascular Assessment
| Heart Sounds |
|
Edema |
|
| Capillary Refill |
|
Perfusion |
|
Neurological Assessment
| Pupil Size/Reaction |
|
Limb Movement |
|
| Sensation |
|
Other Findings |
|
Gastrointestinal Assessment
| Abdominal Status |
|
Feeding |
|
| Bowel Sounds |
|
Last BM |
|
Genitourinary Assessment
| Urine Output |
|
Catheter |
|
| Color/Clarity |
|
Other |
|
Skin/IV Assessment
| Skin Integrity |
|
IV Site |
|
| Pressure Areas |
|
Lines/Drains |
|
Miscellaneous
| Lab Results |
|
| Interventions |
|
| Notes |
|
Nurse Signature