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Health Assessment > assessing skin, hair, and nails > Flashcards

assessing skin, hair, and nails Flashcards

1
Q

Skin basics

A

epidermis outer, four layers. dermis inner

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2
Q

Four layers of epidermis

A

stratum corneum, lucid, granulosum, germinativum

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3
Q

Dermis contains

A

sebaceous glands - oily sebum waterproofs hair/skin. sweat glands - eccrine for sweat/thermoregulation all over. apocrine - puberty, milky sweat

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4
Q

Types of hair

A

vellus - short fine all over. terminal - longer darker coarser (head, eyebrows)

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5
Q

Nails

A

hard plates of keratin. cuticle, nail body, lunula

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6
Q

cuticle

A

where nails grow

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7
Q

nail body

A

extends over nail bed, pink b/c blood under nail bed

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8
Q

Lunula

A

half moon at base of nail (nail matrix)

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9
Q

Questions to ask about skin

A

dryness, oiliness, drainage, bruising, swelling, changes in skin color, pain/itching/tingling/numbness, aggravators, relieve symptoms, body odor/perspiration (too much?)

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10
Q

Old people sweat _____ than young people

A

less

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11
Q

Cultural considerations for sweat

A

asians/native Americans less. African americans/caucasians more

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12
Q

What do you do with a health assessment and history?

A

cluster symptoms

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13
Q

Hair condition

A

loss - could be normal (males), infections, stress, stress on the roots, chemo, meds

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14
Q

Nail conditions

A

malnutrition (different conditions), local irritation (biting), infections (ex: fungal)

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15
Q

Lifestyle and practices related to skin hair and nails

A

sunbathe/tanning booth, sunblock, self examination, immobility, extreme temps, body piercings, tattoos, daily routines (self care), prevent from living normal life?

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16
Q

Looking at health history for skin hair and nails

A

severe sunburns as child, recent hospitalizations/surgeries, skin allergies, recent infections, pregnancy, self injury. family - cancer, allergies, keloids

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17
Q

Equipment for physical exam

A

examination light, penlight, mirror, magnifying glass, centimeter ruler, gloves, wood light, gown, Braden scale, pressure ulcer scale for healing (PUSH)

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18
Q

Skin inspection

A

general coloration - fair at highest risk, older = pale, amount of melanin culturally

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19
Q

Abnormalities in skin color

A

pallor - pale, decreased blood supply. cyanosis - blue, oxygen deficiency (especially nail bed). jaundice - yellow (pale to pumpkin), mostly in sclera, oral mucosa, palms/soles. acanthuses nigricans - dark folds/creases

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20
Q

Central vs peripheral cyanosis

A

central from cardiopulmonary problem, look in oral mucosa. peripheral may be local problem, vasoconstriction. oxygen/perfusion concern

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21
Q

Inspect lesions

A

symmetry, border, shape, color, diameter, changes. use magnifying glass, centimeter ruler, wood light (suspected fungus)

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22
Q

skin integrity

A

intactness, reddened areas, Braden scale, lesions

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23
Q

Skin types

A

1 - always burns never tans (pale)
2 - usually burns sometimes tans (fair)
3 - may burn usually tans (darker skin)
4 - rarely burns always tans (Mediterranean)
5 - moderate constitutional pigmentation (Latin American/Middle Eastern)
6 - marked constitutional pigmentation (black)

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24
Q

Skin palpation

A

texture, thickness, temp, moisture, mobility/edema, turgor

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25
Q

texture

A

use palmar surface of three middle fingers

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26
Q

temp

A

dorsal surface of hands

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27
Q

moisture

A

older may be dryer

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28
Q

mobility

A

less with edema

29
Q

turgor

A

two fingers to pinch skin over clavicle area

30
Q

inspect/palpate scalp

A

wear gloves/separate hair - cleanliness, dryness, oiliness, parasites, lesions. amount/distribution of hair

31
Q

Inspect/palpate nails

A

grooming/cleanliness, color/markings, shape. assess texture/cap refill - <2

32
Q

Normal skin variations

A

freckles, vitiligo (depigmentation), striae (stretch marks), scars, moles, cutaneous horn (ears), cutaneous tag, seborrheic keratosis, cherry angiomas

33
Q

Skin lesion configuration

A

linear, annular, clustered, discrete, nummular, confluent

34
Q

linear

A

straight line like a scratch

35
Q

annular

A

circular lesions

36
Q

clustered

A

lesions grouped together

37
Q

discrete

A

individual and distinct lesions

38
Q

nummular

A

coin shaped lesions

39
Q

confluent

A

smaller lesions run together to form a larger lesion

40
Q

pressure ulcers

A

Stage 1, stage 2, stage 3, unstageable

41
Q

Stage 1 pressure ulcer

A

intact skin, nonblanchable redness

42
Q

Stage 2 pressure ulcer

A

partial thickness loss of dermis, shallow red/pink wound bed, no slough

43
Q

Stage 3 pressure ulcer

A

full thickness tissue loss, may see fat but not bone/tendon/muscle

44
Q

Stage 4 pressure ulcer

A

full thickness tissue loss w/ exposed bone/tendon/muscle, often includes tunneling or undermining

45
Q

Unstageable

A

full thickness tissue loss but base covered w/ slough/eschar, can’t see

46
Q

Primary lesions

A

solid - papule, plaque, nodule, not solid - vesicle, bulla, pustule, wheal, cyst

47
Q

Vascular lesions (abnormalities)

A

petechia, ecchymosis, hematoma, spider angioma

48
Q

Papule

A

circumscribed elevated, palpable, solid mass. <0.5cm

49
Q

nodule

A

elevated solid palpable mass that extends deeper into dermis, 0.5-2cm

50
Q

plaque

A

> 0.5cm, coalesced papules w/ flat top

51
Q

Vesicle

A

circumscribed elevated palpable mass containing serous fluid, <0.5cm

52
Q

bulla

A

circumscribed elevated palpable mass containing serous fluid >0.5cm

53
Q

pustule

A

pus filled vesicle or bulla

54
Q

wheal

A

elevated mass w/ transient borders, often irregular. serous fluid in dermis (not free fluid in cavity)

55
Q

cyst

A

encapsulated fluid filled mass in subcutaneous tissue or dermis

56
Q

petechia

A

pinpoint skin hemorrhage (1-2mm), secondary to blood extravasation, red/purple macule

57
Q

ecchymosis

A

bruise - secondary to blood extravasation, larger than petechia

58
Q

hematoma

A

localized collection of blood, creates elevated ecchymosis

59
Q

Spider angioma

A

red arteriole lesion, central body w/ radiating branches, rarely below waist. compression of center completely blanches

60
Q

ABCDE

A

asymmetry, border, color variations, diameter >6mm, evolution - changes over time

61
Q

abnormalities in color variations

A

Pallor, cyanosis, jaundice, acanthosis nigricans

62
Q

pallor

A

pale to ashen without underlying pink. Due to decreased blood supply (arterial insufficiency)

63
Q

cyanosis

A

blue-tinged. mostly in the pectoral, nail bed, and conjunctival areas. Light skin blue color noted and dark skin blue, dull, and lifeless. Oxygen deficiency

64
Q

jaundice

A

yellow skin tones ranging from pale to pumpkin. They are primarily seen in the sclera, oral mucosa, palms, and soles.

65
Q

acanthosis nigricans

A

velvety darkening of the skin in body folds and creases. especially the neck, groin, and axilla.

66
Q

Central cyanosis

A

results from cardiopulmonary problems. Look for central cyanosis in the oral mucosa.

67
Q

peripheral cyanosis

A

local problem. Vasoconstriction.

68
Q

So a skin color variation indicates an oxygenation and perfusion concern?

A

Yes….. the body is connected

Health Assessment (32 decks)

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