Handout 5 Skin and Nails

Question 1

is the first part of the physical examination that begins the moment the nurse meets the client.
It requires the nurse to use all of her observational skills while interviewing and interacting with the
client. These observations will lead to clues about the health status of the client.
 The outcome of the general survey provides the nurse with an overall impression of the client’s
whole being

Answer 1

The general survey

Question 2

General survey includes:

Answer 2

Physical development and body build
* Gender and sexual development
* Apparent age as compared to reported age
* Skin condition and color
* Dress and hygiene
* Posture and gait
* Level of consciousness
* Behavior, body movement and affect
* Facial expression
* Speech
* Vital signs

Question 3

largest organ of the body
Purpose:
* Protection
* Thermoregulation
* Electrolyte balance
* Excretion
* Sensation
* Immunity
* Vitamin D synthesis

Answer 3

SKIN

Question 4

Layers of the Skin

Answer 4

Epidermis
Dermis
Subcutaneous tissue

Question 5

– outer layer of the skin
dead keratinized cells
replaced every 3-4 weeks

Answer 5

Epidermis

Question 6

layers of epidermis

Answer 6

Stratum corneum (
 Stratum lucidum
 Stratum granulosum
 Stratum germinativum (basale)

Question 7

– inner layer of the skin

with artery and vein
Well vascularized connective tissue layer containing collagen, elastic, fibers, nerve endings and lymph vessels.

Sebaceous glands, sweat glands and hair follicles

Answer 7

Dermis

Question 8

connective tissue
containing fat cells, blood vessels, nerves,
and
the remaining portions of sweat glands and hair
follicles

Answer 8

Subcutaneous tissue –

Question 9

SKIN DISCOLORATIONS

Answer 9

PALLOR (pale) -
 JAUNDICE (yellow-orange)
 CYANOSIS (blue) -
 ERYTHEMA

Question 10

result of inadequate circulating blood or hemoglobin, cause: anemia

Answer 10

PALLOR (pale)

Question 11

resulting from accumulation of bilirubin

Answer 11

JAUNDICE (yellow-orange)

Question 12

increased concentration of deoxyhemoglobin, cause: heart or lung
disease

Answer 12

CYANOSIS (blue)

Question 13

• resulting from rashes, causes:fever, trauma, blushing, alcohol
  intake

Answer 13

ERYTHEMA (redness)

Question 14

cell division and contains melanin (brown pigment and keratin, forming cells

Answer 14

stratum germinativum

Question 15

– unique pattern of friction ridges (fingerprints)

Answer 15

Dermal Papillae

Question 16

Secrete oily substance called sebum that waterproofs the hair and skin

Answer 16

SEBACEOUS GLANDS

Question 17

Two types SWEAT GLANDS

Answer 17

Apocrine
Eccrine

Question 18

(axillae, perineum & areolae – body odor )

Answer 18

Apocrine

Question 19

sweat and thermoregulation

Answer 19

Eccrine

Question 20

Loose connective tissue containing fat, cells, blood vessels.
Stores fat as an energy reserve, provides insulation, serve as cushion to protect bones and internal organs, supply of nutrients and removal of waste products to and from the skin.

Answer 20

SUBCUTANEOUS TISSUE

Question 21

consist of keratinized cells, found all over the body except lips, nipples, soles of the feet, palms of the hands, labia minora and penis

Answer 21

HAIR

Question 22

Hair develops within epidermal cells called

Answer 22

hair follicle

Question 23

goose flesh (fight or flight)

Answer 23

Arector Pili Muscle

Question 24

TWO TYPES OF HAIR

Answer 24

VELLUS HAIR
TERMINAL HAIR

Question 25

– short, pale, fine, present much of the body. > thermoregulation, provides insulation,

Answer 25

VELLUS HAIR

Question 26

scalp and eyebrows, longer, generally darker and coarser

Answer 26

TERMINAL HAIR

Question 27

>Distal phalanges of fingers and toes are hard, transparent plates of keratinized epidermal cells that grow from the cuticle. protect the distal ends of the fingers, toes, enhance precise movement of the digits and allow for an extended precision grip.

Answer 27

NAILS

Question 28

PARTS of Nails

Answer 28

Nail Body Lunula

Question 29

extends over the entire the nail bed and has a pink tinge as a result of blood vessels underneath

Answer 29

Nail Body

Question 30

crescent- shaped area located at the base of the nail.

Answer 30

lunula

Question 31

unusual increase in hair growth or change in condition of your hair

Answer 31

HAIR LOSS

Question 32

infections, stress, chemotherapy. Generalize hair loss (hyperthyroidism) Malnutrition, anorexia nervosa and bulimia Hair Loss, Baldness is common in aging

Answer 32

ALOPECIA ( patchy hair loss)

Question 33

– increased production of male hormones

Answer 33

Hirsutism

Question 34

– Yellow thick, crumbling nails

Answer 34

Fungal Infections

Question 35

white color, separation of the nail plate from the nail bed. 6 months – fingernail 12 months – toenails

Answer 35

Yeast Infections

Question 36

Sunburns/tanning, sunblock - premature aging of skin Skin self examination Exposed to chemical/iritants Sitting/lying in one position Exposure to extreme temperature - frostbites/burns Body piercings/Tattoos - risk for infection, keloid, Hepatitis C infection Daily routine/products used History of smoking/drinking alcohol - Psoriasis skin disorder - Stress

Answer 36

LIFESTYLE & HEALTH PRACTICES

Question 37

linear streak like pattern in dark skinned people, suggest DM

Answer 37

Acanthosis Nigricans –

Question 38

or white patches (different amounts of melanin in certain areas

Answer 38

– VITILIGO

Question 39

– generalized loss of pigmentation Dark Skinned Clients have lighter colored palms, soles, nail beds and lips. Pale or light skinned clients have darker pigment around nipples, lips and gneitalias

Answer 39

ALBINISM

Question 40

Inspect skin color assess skin integrity inspect for lesions

Answer 40

SKIN - INSPECTION

Question 41

assess texture assess thickness

Answer 41

skin-palpation

Question 42

sweating

Answer 42

diaphoresis

Question 43

how easily the skin is pinched

Answer 43

Mobility

Question 44

skin elasticity and how quickly the skin returns to its original shape after being pinched.

Answer 44

Turgor