Examination of integumentary integrity

Question 1

Pruritis

Answer 1

itching

common in diabetes, drug hypersensitivy, hyperthyroidism

Question 2

Urticaria

Answer 2

smooth, red, elevated patches of skin, hives

indicative of an allergic response to drugs or infection

Question 3

Rash

Answer 3

local redness and eruption on the skin
typically accompanied by itching
Seen in inflammation, skin diseases, chronic alcoholism, vasomotor disturbances, pyrexia, medications

Question 4

Xeroderma

Answer 4

Excessive dryness of skin with shedding of epithelium

can indicate deficiency of thyroid function, diabetes

Question 5

Edema can indicate

Answer 5

anemia, venous or lymphatic obstruction, inflammation - cardiac, circulatory, or renal decompensation

Question 6

Changes in nails - clubbing

Answer 6

Thickened and rounded nail end with spongy proximal fold

Question 7

Changes in nails - clubbing can be indicative of what

Answer 7

Can be indicative of Crohn’s or cardiac cyanosis, lung pathology, ulcerative colitis, biliary cirrhosis, neoplasm, GI involvement

Question 8

Changes in nails - clubbing - schamroth’s window test

Answer 8

loss of diamond shape space when nails are placed back to back of opposite hands
often positive with clubbing

Question 9

Changes in nails - splinter hemorrhages

Answer 9

small areas of bleeding under nails that look like splinters
Potential for cardiac or renal signs

Question 10

Changes in skin color - cherry red could indicate (palmar)

Answer 10

palmar erythema could indicate liver or renal issues

Question 11

Changes in skin color - cyanosis

Answer 11

slightly bluish, grayish, slate colored discoloration

Indicative of lack of oxygen - can indicate CHF, advanced lung disease, venous obstruction

Question 12

Changes in skin color - pallor

Answer 12

lack of color, paleness
Can indicate anemia, internal hemorrhage, lack of exposure to sunlight
Temporary pallor seen with arterial insufficiency and syncope, chills, shock, vasomotor instability, or nervousness

Question 13

Changes in skin color - yellow

Answer 13

indicates jaundice, liver disease
look for yellow in sclera of eyes, lips, and skin
Orange yellow occurs with increased carotene intake

Question 14

Changes in skin - liver spots

Answer 14

Brownish, yellow spots may be due to aging, uterine and liver malignancies, pregnancy

Question 15

Changes in skin - brown

Answer 15

increased pigmentation sometimes associated with venous insufficiency

Question 16

Changes in hair - alopecia

Answer 16

hair loss

Question 17

Changes in hair - hypothyroidism

Answer 17

thinning hair

Question 18

Changes in hair - hyperthyroidism

Answer 18

silky hair

Question 19

Changes in hair - hirsutism

Answer 19

male pattern hair growth in women

can indicate polycystic ovary syndrome, cushing’s tumor or an inherited trait

Question 20

Presence of lesions, unusual growth - Flat spot

Answer 20

macule (small - up to 1 cm)

patch (1cm or greater)

Question 21

Presence of lesions, unusual growth - Palpable elevated solid mass

Answer 21

papule (small, up to 1 cm)
plaque (elevated, 1 cm or larger)
nodule (marble like lesion)
wheal (irregular, localized skin edema like hives)

Question 22

Presence of lesions, unusual growth - Elevated lesions with fluid cavities

Answer 22

vesicle (up to 1 cm, contains serous fluid)
bulla or blister (1 cm or greater, contains serous fluid)
pustule (contains pus)