General Appearance Assessment

Healthy/Well-appearing: Looks robust, energetic, comfortable.

Acutely Ill: Appears suddenly unwell, in distress, often with signs of pain or difficulty breathing.

Chronically Ill: Frail, fatigued, signs of long-term illness.

Frail: General weakness, muscle loss, slow movements.

Assess how awake and aware the patient is:

• Alert: Awake and responsive.
• Lethargic: Drowsy but responsive to voice.
• Obtunded: Very drowsy, responds slowly.
• Stuporous: Arouses only to pain.
• Comatose: No response to any stimuli.

Orientation: Person, Place, Time.

• Pain: Grimacing, guarding, moaning.
• Respiratory Distress: Labored breathing, nasal flaring.
• Anxiety/Fear: Restlessness, sweating, rapid speech.
• Cardiac Distress: Chest pain, pallor, sweating.

• Underweight/Cachectic: Severely thin, muscle wasting.
• Normal Weight: Healthy range for height.
• Overweight/Obese: Excess body fat.
• Body Proportions: Disproportion may indicate syndromes.

• Posture: Upright, slumped, rigid.
• Gait: Smooth, shuffling, unsteady, antalgic.
• Motor Activity: Restlessness, tremors, tics, paralysis, limited movement.

• Cleanliness: Well-groomed or disheveled.
• Odor: Body odor, alcohol, urine, unusual scents.
• Clothing: Clean, appropriate, or soiled.
• Hair/Nails: Groomed or neglected.

• Pallor: Pale, possibly anemic.
• Cyanosis: Blue tinge, poor oxygenation.
• Jaundice: Yellow skin/sclera, possible liver disease.
• Flushing: Redness from fever or emotion.
• Rashes/Lesions: Bruising, eruptions, growths.

• Expression: Relaxed, anxious, sad, mask-like.
• Affect: Appropriate, flat, labile, blunted.

• Clarity: Clear, slurred, hoarse, mumbled.
• Rate: Slow or rapid.
• Volume: Soft or loud.
• Coherence: Logical, organized speech.