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Nursing 314: Assessing and Promoting Wellness > Exam 3: Skin, hair, nails > Flashcards

Exam 3: Skin, hair, nails Flashcards

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1
Q

Skin is like a

A

window for viewing changes that take place within the body

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2
Q

Inspect and palpate skin for

A 
Color & presence of lesions 
Moisture 
Temperature 
Texture & thickness
Turgor 
Vascularity 
Edema 
Pain response w/ palpation
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3
Q

Chloasma

A
  • Darker pigmentation on forehead, nose, and cheeks “mask of pregnancy”
  • Usually fades after birth
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4
Q

Linea Nigra

A

Darkened line from umbilicus to symphysis pubis

  • Darkening of areola
  • Usually fades after birth
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5
Q

Normal/benign pregnancy skin variations

A

Chloasma

Linea nigra

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6
Q

Normal or benign newborn skin markings

A

Milia
Mongolian spots
Erythema toxicum
Stork bike (nevus simplex)

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7
Q

Milia

A

Unopened/clogged sebaceous glands that usually appear on nose and cheeks

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8
Q

Mongolian spots

A

Normal in dark-skinned infants during 1st few years of life

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9
Q

Erthema toxicum

A

Transient maculopapular rash; may be due to increased eosinophil activity

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10
Q

Stork bite (nervous simplex)

A

Caused by dilation of small capillaries; regress spontaneously

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11
Q

Sebaceous Glands in elderly

A

Decrease in size, number, and output

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12
Q

Decreased output of the sweat glands cause

A

Senile Xerosis
Skin itches
Looks flaky and loose

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13
Q

Senile Xerosis

A

Age related dry skin

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14
Q

Age related skin changes

A 
Paper-thin, transparent skin 
Wrinkles
Actinic lentigo
Cherry hemangiomas 
Skin tags
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15
Q

Wrinkles

A

Decrease elastin and subcutaneous tissue

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16
Q

Actinic lentigo: liver spots

A

Normal with aging

Cluster of melanocytes on dora of hands and forearms

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17
Q

Cherry hemangiomas

A

Common and arise in middle-ages to older adults

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18
Q

Cherry hemangioma is a

A

Vascular lesion

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19
Q

Cherry hemangiomas usually located on

A

the trunk

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20
Q

Cherry (senile) hemangiomas increase in what with age

A

Increase in size and number

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21
Q

Are Cherry (senile) hemangiomas a concern?

A

No, they are benign

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22
Q

Skin tags

A

Overgroths of normal skin that forms a stalk

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23
Q

skin tags are frequently on

A

eyelids
cheeks and neck
axillae and trunk

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24
Q

Skin tags are more common with

A

diabetes

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25
Q

Turgor indicates

A

Elasticity and overall hydration

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26
Q

turgor can be altered by

A

Water content

Aging

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27
Q

How to check turgor

A

Pinch skin and release

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28
Q

If skin has normal elasticity and hydration, it will

A

Immediately return to its original state after pinching

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29
Q

Poor skin turgor is

A

tenting of the skin with a slow return to the original

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30
Q

Skin/mucous membrane color comes from

A 
melanin 
carotene 
oxyhemoglobin 
deoxyhemoglobin 
bilirubin
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31
Q

Pallor

A

Observed most readily in the palms, nail beds, face, and conjunctiva

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32
Q

Pallor is caused by

A 
Lowered Hgb content 
fight or flight response 
Medications 
Cold 
Shock
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33
Q

Red/erythema increased visibility of

A

Hgb

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34
Q

red/erythemic skin cause what with hand pressure

A

Blanches

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35
Q

Red/erythema is often related to

A

inflammation

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36
Q

is red/erythmea skin the same as burns?

A

No!

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37
Q

Blue/cyanosis is increased

A

Geoxyhemoglobin (Hhb=hypoxia/hypoxemia)

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38
Q

Blue/cyanosis often related to

A

cardio/pulmonary diseases or end of life

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39
Q

Jaundice

A

Excess bilirubin

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40
Q

Carotenoderma / Carotenemia:

A

(blood levels 4X normal)

Eyes remain white!

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41
Q

Ephelides (freckles)

A

Small brown macule on sun exposed skin of fair skinned individuals

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42
Q

Cafe-au-lait

A

A light brown, oval macule (dark brown on brown or black skin) found anywhere on the body

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43
Q

Loss of pigmentation

A

Vitiligo

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44
Q

Vitiligo is

A

Congenital

Autoimmune

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45
Q

Assessment methods for dark skin: Pallor

A

Use good lighting

Mucous membranes ash-gray color: absence of underlying red tones that give skin a healthy glow

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46
Q

Assessment methods for dark skin: Cyanosis

A

Lips & tongue are grayish

Palms, soles, conjunctivae, & nail beds have a bluish tinge

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47
Q

Assessment methods for dark skin: Erythema

A

How to assess for inflammation in a dark-skinned patient?

  • Compare palpation with other areas of the body.
  • Ask about pain in the area
  • Palpate for edema/induration
  • Moisten skin to look for redness
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48
Q

Ski lesions are grouped according to

A

fluid-filled versus solid, diameter, compare scaling versus flat, etc.

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49
Q

Flat lesion

<0.5 cm diameter

A

Macule

50
Q

Flat lesion

>0.5 cm diameter

A

Patch

51
Q

Elevated. fluid filled with pus, and regular

A

Pustules

52
Q

Elevated, fluid filled with serous, <0.5 cm diameter

A

Vesicle

53
Q

Elevated, fluid-filled with serous, > 0.5 cm in diameter

A

Bulla

54
Q

elevated, edematous, and generally irregular/transiet

A

Hives !

55
Q

Hives are

A

Whelts/ wheals

56
Q

Annular:

A

Circular, ring-like, raised, border around normal skin

57
Q

Circunate

A

Circular

58
Q

Circumscribed

A

Well-define borders

59
Q

Clustered

A

Grouped together

60
Q

Coalesced

A

Lesions that merged together

61
Q

Diffuse

A

Wide-spread/generalized

62
Q

Linear

A

Straight line

63
Q

Universal

A

All over with no “normal” skin

64
Q

Ecchymosis

A

Larger area of bleeding associated with injury

— may be caused by drugs, low platelets, clotting disorders

65
Q

Purpuric lesions

A

Less vessels burst without trauma/injury

66
Q

Purpura & petechiae

A

Often due to low platelets or clotting disorders causing increased capillary fragility

67
Q

Purpura & Petechiae are

A
  • Non-blanching (do not fade w/pressure)
  • petechiae 1-3mm, flat, pinpoint
  • Purpura generally larger than petechiae
68
Q

Tattooing medical complications are rare, but mainly related to

A

pigment ingredients, but include viral, bacterial, fungal, and diseases

69
Q

Piercing medical complications are common:

A

Metal-induced contact allergic dermatitis, broken teeth, anesthetic risks & infections of all types

70
Q

Malignant moles are typically

A

Asymmetrical
Uneven borders
Two or more shades
Larger than 1/4 inch

71
Q

Skin malignancies

A

Basal cell carcinoma
Squamous cell carcinoma
Melanoma

72
Q

Nails protects

A

Vital ends of fingers and toes

73
Q

Nail plate

A

Pink color from vascular nail bed beneath

74
Q

Nail matrix

A

Site of growth; protected by cuticle

75
Q

Lunula

A

White crescent-shaped area that extends beyond cuticle; the visible portion of the nail matrix

76
Q

Dystrophic nails may occur with a

A

Serious systemic illness or local skin disease involving the epidermal keratinocytes

77
Q

variations in color, texture, & grooming of the nails are influenced by

A

factors unrelated to disease, such as occupation, personal preferences, or customs

78
Q

Color of the nail plate depends on

A 
Thickness
Transparency
Amount of red blood cells
Arterial blood flow
Pigment deposits
79
Q

Cgnages in nail color can be caused by

A

Chemical damage that occurs with some occupations or with long-term use of nail polish

80
Q

Regardless of skin color, the healthy nail

A

Blanched (lightens) with pressure

81
Q

To differentiate between color changes from the underlying vascular supply problems & those resulting from pigment deposition assess capillary refill

A

Vascular alterations

Pigment alterations

82
Q

Vascular alterations

A

Color will change as pressure it applied and returns to the original state when released

83
Q

Noting the rate of return of color for vascular alterations:

A

Indicates the status of the peripheral circulation

84
Q

Pigment alterations

A

color remains unchanged with or without pressure

85
Q

Clubbing

A

Bulbous swelling of soft tissue of terminal phalanx of the digit

86
Q

Clubbing is associated with

A

Pulmonary, cardiovascular, infectious, neoplastic, and other disorders

87
Q

Schamroth

A

Loss of diamond shape formed when right and left thumbs are opposed in person
– positive sign means abnormal clubbing

88
Q

Beau Lines

A

Transverse, band-like depressions in nail

89
Q

Beau Lines etiology

A

Damage to matrix

90
Q

Beau lines can occur after

A
  • Severe, sudden, acute, sometimes febrile illness;

- Severe reactions to drugs/cytotoxic drugs (e.g. chemotherapy, as in top photo)

91
Q

Onycholysis

A
  • Detachment of nail from its bed at distal &/or lateral attachments
92
Q

Etiology of onycholysis

A

idiopathic, mechanical or chemical damage; also associated with psoriasis

93
Q

Onychomycosis

A

Invasion of the nail by fungus

-affects up to 14% of population with increasing prevalence among older individuals

94
Q

Age-related nail changes

A
  • Gradual thickening of the nail plate
  • Longitudinal ridges
  • Yellowish gray discoloration
95
Q

what is responsible for forming hairs

A

Cells of the germinal matrix responsible

96
Q

Cells of the germinal matrix undergoes repeated

A

Mitosis, push upward in the follicle, and become keratinized to form a hair

97
Q

As long as the cells of the germinal matrix remain alive,

A

hair regenerates even though it is cut, plucked, or otherwise removed

98
Q

A common type of baldness occurs when two requirements are met:

A

genes for baldness + male sex hormones (androgens)

99
Q

When the right combination of these causative factors exist (genes for baldness + male sex hormones)

A

Androgenic alopecia or

Male pattern baldness inevitably results

100
Q

Sudden or marked changes in hair characteristics may reflect

A

an underlying disease process

101
Q

Intense itching/scratching for hair

A

Examine the scalp & pubis for lice and nits

102
Q

Nits

A

Lice eggs

103
Q

Inspect scalp for

A

Scaling, redness, open areas, crusting, tenderness

104
Q

Dandruff

A

Collection or patchy or diffuse white/gray scales on the surface of the scalp

105
Q

Flaking from dandruff causes people to mistakenly think the scalp is

A

too dry, however, it is excessive oil production

106
Q

Pediculosis

A

Infestation with any of several kinds of lice

107
Q

Types of lice encountered most frequently

A

Pediculus humanus capitis
Pediculus humanus corporis
Phthirus pubis

108
Q

Pediculus humanus capitis

A

Head louse

109
Q

Pediculus humanus corporis

A

Body louse

110
Q

Phthirus pubis

A

Pubic or crab louse

111
Q

louse (lice) requires

A

BLOOD

112
Q

infestation of louse causes

A

Pruritus (result of sensitization to louse saliva)

113
Q

Scratching from lice can result in

A

secondary bacterial infections

114
Q

Head lice reside on the

A

Scalp, lay nits (eggs) on hair

115
Q

The head louse can be found infesting people from

A

All socioeconomic groups

116
Q

Can lice be acquired through contact with pets or other animals?

A

No!

117
Q

Hirsutism

A

Condition of male-pattern hair growth in women

118
Q

Hirsutism may arise

A

from excess male hormones called androgens, primarily testosterone

119
Q

Hair of older individuals looks gray or white due to

A

decrease in number of functional melanocytes

120
Q

Although gradual hair loss occurs with aging, sudden asymmetric or patchy hair loss at any age

A

is of concern

Nursing 314: Assessing and Promoting Wellness (26 decks)

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