How to do neuro checks (pupils, consciousness, movement)
Other platforms explain it with text and video. In Making Synapses you practice it on the patient.
Neuro checks repeated over time catch changes early after head injury, stroke or surgery.
Step by step
Level of consciousness
Alert, drowsy, responds to voice or pain. [1]
Orientation
Name, place, time. [1]
Glasgow Coma Scale
Eyes, verbal, motor; total 3 to 15. [1]
Pupils
Size, shape, equality, reaction to light. [1]
Movement and strength
Hand grip, pushing with the feet, both sides. [1]
Vital signs
High blood pressure with slow pulse and irregular breathing is late and urgent. [1]
Report changes
A drop of 2 or more in GCS, a new unequal pupil or new weakness: call right away. [1]
Common errors
- Only checking pupils.
- Not comparing with the last check.
- Waiting to report a change.
Practice it in Making Synapses
In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
Making Synapses cases that train this skill
- Poststreptococcal glomerulonephritis
- Opioid overdose in the waiting room
- Opioid withdrawal after surgery
- Diabetic ketoacidosis
- Suspected child abuse
- Altered mental status, unknown cause
44 Making Synapses cases train this skill: open the case library
Sources
- Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)
- OpenStax, Clinical Nursing Skills (reference)
Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. Facts and steps also follow OpenStax, Clinical Nursing Skills (reference). Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.