Chapter 12: skin, hair, and nails Flashcards
What are the developmental differences in skin?
Young
Immature skin
Unable to prevent fluid loss
Unable to help regulate temperature
Older adult
Stratum Corneum thins and flattens
Wrinkling occurs
Vascular fragility increases
What are things kept in mind about cross cultural care?
Increased Melanin
Decreased incidence of skin cancer
Skin conditions specific to blacks Keloids Pigmentary Disorders Pseudofolliculitis Melasma
What are keloids?
-overgrowth of scar tissue
What is psuedofolliculitis?
- numerous smooth little tender red bumps involve the hair follicles commonly on the face, scalp, chest, back, buttocks, and legs
- inflammatory reaction surrounding ingrown facial hairs which results from shaving. It is also known as shaving rash or razor bumps
What is melasma?
common skin problem causing brown to gray brown patches usually on the face
-can be triggered by pregnancy, sun, genetic predisposition, and hormonal changes
What are some health history questions for subjective data collection?
Previous history of skin disease: (allergies, hives, psoriasis, or eczema) Change in mole Change in pigmentation (size or color) Excessive dryness or moisture Pruritus Excessive bruising
Rash or lesion Medications Hair loss or change in texture Change in nails Environmental or occupational hazards Self-care behaviors
What is pruritus?
severe itching of the skin
What is the objective data collected for scalp and hair?
color
quantity
distribution
-the expected findings: even color, full distribution
What is alopecia?
the partial or complete absence of hair from areas of the body where it normally grows; baldness
What are the expected findings for hair texture?
fine/thick/curly/kinky etc
uniform
What are unexpected findings for hair texture?
dry/brittle
sparse
What are the expected findings for the scalp?
clear/mobile
What are the unexpected findings for the scalp?
lesions/parasites
What are the expected findings for nails?
Rounded shape, pink, well-adhered, nail base firm, brisk capillary refill, 160 degree angle of attachment
What are the unexpected findings for nails?
Clubbing, cyanosis, pallor, >160 degree angle of attachment, capillary refill > 3 seconds (delayed)
What is clubbing?
Drumstick fingers, watch-glass nails. Clubbing. … Nail clubbing, also known as digital clubbing, is a deformity of the finger or toe nails associated with a number of diseases, mostly of the heart and lungs.
What is cyanosis?
a bluish discoloration of the skin resulting from poor circulation or inadequate oxygenation of the blood.
What are the expected findings for color and pigmentation?
Uniform and consistent throughout
Ethnic Appropriate
Pink for Caucasians
Evenly Pigmented
What are the unexpected findings for color and pigmentation?
Pallor Cyanosis Jaundice Erythema Hypopigmentation Hyperpigmentation Vitiligo
What is pallor?
unhealthy pale appearance
What is jaundice?
Jaundice is the medical term that describes yellowing of the skin and eyes. … Jaundice forms when there is too much bilirubin in your system. Bilirubin is a yellow pigment that is formed by the breakdown of dead red blood cells in the liver. Normally, the liver gets rid of bilirubin along with old red blood cells.
What is erythema?
superficial reddening of the skin, usually in patches, as a result of injury or irritation causing dilatation of the blood capillaries.
What is hypopigmentation?
Hypopigmentation is the loss of skin color. It is caused by melanocyte or melanin depletion, or a decrease in the amino acid tyrosine, which is used by melanocytes to make melanin.
What is hyperpigmentation?
Hyperpigmentation is a common, usually harmless condition in which patches of skin become darker in color than the normal surrounding skin. This darkening occurs when an excess of melanin, the brown pigment that produces normal skin color, forms deposits in the skin.
What is vitiligo?
Vitiligo (vit-ill-EYE-go) is a disorder in which white patches of skin appear on different parts of the body. This happens because the cells that make pigment (color) in the skin are destroyed. These cells are called melanocytes (ma-LAN-o-sites). Acquired condition Complete absence of melanin pigment Irregular in shape Can occur in all races Threat to self-image only
What are the expected findings for temperature?
warm
equal bilaterally and throughout
What are the unexpected findings for temperature?
hypothermia
hyperthermia
hot spots
What is the dorsa of the hand used for in palpation?
temperature
What is hypothermia?
the condition of having an abnormally low body temperature, typically one that is dangerously low.
What is hyperthermia?
the condition of having a body temperature greatly above normal.
What are the expected findings for skin moisture?
dry and equal bilaterally throughout
What are the unexpected findings for skin moisture?
diaphoresis
dehydration
What is diaphoresis?
sweating, especially to an unusual degree as a symptom of disease or a side effect of a drug.
What are the expected findings for skin texture?
smooth/firm and even throughout
What are the unexpected findings for skin texture?
rough
scaly
excessively dry (xerosis)
What are expected findings for skin thickness?
uniform throughout
What are unexpected findings for skin thickness?
thin shiny skin
What are the expected findings for skin mobility and turgor?
rises and returns: ELASTIC
What are unexpected findings for mobility and turgor?
tenting
edema
What is tenting?
Poor skin turgor occurs with vomiting, diarrhea, or fever. The skin is very slow to return to normal, or the skin “tents” up during a check. This can indicate severe dehydration that needs quick treatment. You have reduced skin turgor and are unable to increase your intake of fluids (for example, because of vomiting).
What is edema?
Fluid accumulating intercellular spaces Most evident in dependent body parts Pitting or non-pitting 1+ to 4+ scale Unilateral, bilateral or generalized
How are lesions characterized?
Color Elevation Pattern or shape Size in cm Location and distribution on body Exudate Border Presence of odor Description of drainage
What is the ABCDE accronym for skin self examination?
A—asymmetry B—border C—color D—diameter E—elevation and enlargement
What are two types of purpuric lesions?
petechiae
purpura
What is the petechiae lesion?
pinpoint hemorrhages, round discrete 1-3mm
What is the purpura lesion?
extensive/confluent greater than 3mm
What are primary skin lesions?
Macule Papule Patch Plaque Nodule Wheal Tumor Urticaria (hives) Vesicle Cyst Bulla Pustule
What are secondary skin lesions?
Crust Scale Fissure Erosion Ulcer Excoriation Scar Atrophic scar Lichenification Keloid
What are some common shapes and configurations of lesions?
Annular or circular
Confluent
Discrete
Grouped
Gyrate
Target or iris
Linear
Polycyclic
Zosteriform
