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NURS 5200 Holistic Health Assessment & Therapeutics for the Advanced Practice Nurse > Integumentary System > Flashcards

Integumentary System Flashcards

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1
Q

Functions of the Skin

A

Protects against microbial/foreign substance invasion and minor physical trauma
Restricts body fluid loss; provides a restrictive barrier
Regulates body temperature
Provides sensory perception via free nerve endings and specialized receptors
Produces vitamin D from precursors in the skin
Contributes to blood pressure regulation through constriction of skin blood vessels
Repairs surface wounds by exaggerating the normal process of cell replacement
Excretes sweat, urea, and lactic acid
Expresses emotions

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2
Q

History of Present Illness: Skin

A 
Changes in skin
Temporal sequence
Symptoms
Location
Associated symptoms
Recent exposure
Apparent cause
Travel history
Treatment response
Adjustment  to problem
Medications
Trauma
Bites
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3
Q

HPI: Hair

A 
Changes in hair
Occurrence
Associated symptoms
Exposure
Infestation
Nutrition
Treatment 
Adjustment
Medication
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4
Q

HPI: Nails

A 
Changes in nails
Recent history
Associated symptoms
Temporal sequence
Exposure
Treatment response
Medications
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5
Q

Skin - PMH

A

Previous skin problems
Lesions, treatment
Tolerance to sunlight, number of sunburns
Diminished or heightened sensitivity to touch
Cardiac, respiratory, liver, endocrine, or other systemic disease
Pruritis

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6
Q

Hair PMH

A

Previous hair problems

Systemic problems

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7
Q

Nail - PMH

A

Previous nail problems
Nail injury
Bacterial, fungal, or viral infection

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8
Q

Systemic problems

A

Associated skin disorder
Congenital anomalies
Respiratory, cardiac, endocrine, hematologic, or other systemic diseases

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9
Q

Family Hx

A

Current or past dermatologic diseases or disorders in family members
Allergic hereditary diseases: asthma, allergic rhinitis
Familial hair loss or pigmentation patterns

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10
Q

Personal and social history

A

Skin, hair, nail care habits
Skin self-examination
Exposure to environmental/occupational hazards
Recent psychologic or physical stress
Use of alcohol, tobacco, or recreational drugs
Sexual history

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11
Q

Equipment

A

Centimeter ruler
Flashlight or penlight
Handheld magnifying lens or dermatoscope
Wood’s lamp – to view fluorescing or depigmented lesions

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12
Q

Inspection

A

Adequate lighting
Inspect skin, re-drap or cover areas not inspecting for warmth and modesty
Inspect the skin in two ways
Overall visual sweep of the entire skin surface
Observe the skin as each part of the body is examined

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13
Q

Note 6 characteristics in each part of the body

A 
Color
Uniformity
Thickness
Symmetry
Hygiene
Presence of any lesions, which are any pathologic skin change or occurrence.
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14
Q

Palpation

A

Palpate to detect moisture..
Use the dorsal surface of your hands to assess temperature.
Check the texture, which should be smooth, soft, and even.
Roughness on exposed skin or areas of pressure may occur.
Evaluate turgor and mobility

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15
Q

Lesions - Note:

A

Size (measured in centimeters in all dimensions)
Shape
Color
Texture
Elevation or depression
Attachment at the base
If exudate – note color, odor, amount, and consistency

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16
Q

If more than one lesion, note if it is:

A 
Annular (or ring-shaped)
Arciform (or bow-shaped)
Grouped
Linear
Diffuse.
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17
Q

Record lesions’ location and distribution

A

Generalized or localized
Affect a specific body region
Form a pattern
Discrete or confluent

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18
Q

Use a light and magnifying glass to determine

A

the lesion’s subtle details, including color, elevation, and borders.

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19
Q

To see if fluid is present in a cyst

A

or mass, trans-illuminate it in a darkened room.

A fluid-filled lesion trans-illuminates with a red glow; a solid lesion does not.

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20
Q

To further identify a lesion, shines a

A

Wood’s lamp on the area in a darkened room

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21
Q

Use inspection and palpation to assess

A

the hair:
Palpate its texture.
Inspect the hair for three characteristics: color, distribution, and quantity.

Palpate hair for texture and fragility
Hair distribution and quantity

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22
Q

Inspect the nails for six characteristics:

A 
Color
Length
Condition
Configuration
Symmetry
Cleanliness
23
Q

Measure the nail-base angle

A

The nail-base angle should measure 160 degrees

If the nail-base angle is 180 degrees or more, clubbing is present, which suggests a cardiopulmonary or other disorder.

24
Q

Inspect and palpate theproximal and lateral nail

A 
folds
Palpate the nail platefor four characteristics:
Texture
Firmness
Thickness
Adherence to the nail bed.
25
Q

ABCDE’s of Mole Assessment

A 
Asymmetry
Border
Color
Diameter
Evolving
Additionally know the various types of skin cancer AND the most common type of skin cancer.
26
Q

Infants and Children

A

Vernix caseosa, a mixture of sebum and cornified epidermis, covers the newborn’s body at birth.
Subcutaneous fat is poorly developed in newborns, predisposing them to hypothermia.
Lanugo is the fine silky hair that covers the newborn’s body, particularly on the shoulders and back.
Desquamation of stratum corneum may be present at birth or very shortly afterward.
Eccrine glands function after 1 month.
Apocrine glands do not function.

27
Q

Adolescents

A

Apocrine glands enlarge and become active.
Increased axillary sweating and body odor
Increased sebum production in response to increased hormone levels, primarily androgen
Oily appearance predisposing the individual to acne
Coarse terminal hair appears in the axillae and pubic areas of both female and male adolescents, and on the face of males.

28
Q

Pregnancy

A

Increased blood flow to skin, especially that of the hands and feet, results from peripheral vasodilation and increased numbers of capillaries.
Acceleration of sweat and sebaceous gland activity occurs.
Spider angiomas and cherry hemangiomas that are present may increase in size.
Skin thickens; fat is deposited in subdermal layers.
Skin stretching, increased pigmentation, nevi changes

29
Q

Older Adults

A

Sebaceous and sweat gland activity decreases: results in dry skin and less perspiration.
Epidermis thins and fragility increases.
Loss of collagen and decreasing elasticity causes wrinkles.
Subcutaneous tissue decreases.
Gray hair from decreased melanocytes occurs.
Scalp and body hair decrease; baldness.
Facial hair develops in women.
Nail growth slows.

30
Q

Annular

A

ring shapped

31
Q

arciform

A

bow shaped

32
Q

nail base angle should measure

A

160 degrees

if it is 180 degrees or more, clubbing is present, which suggests a cardiopulmonary or other disorder

33
Q

Vernix caseosa, a mixture of

A

sebum and cornified epidermis, covers the newborn’s body at birth.

34
Q

Subcutaneous fat is poorly developed in

A

newborns, predisposing them to hypothermia.

35
Q

Lanugo is the fine silky

A

hair that covers the newborn’s body, particularly on the shoulders and back.

36
Q

Desquamation of stratum corneum may be

A

Desquamation of stratum corneum may be

37
Q

Eccrine glands function

A

after 1 month.

38
Q

Children - Apocrine glands do not

A

function

39
Q

Adolecents - Apocrine glands

A

Apocrine glands enlarge and become active.

Increased axillary sweating and body odor

40
Q

Adolecents increased sebum

A

Increased sebum production in response to increased hormone levels, primarily androgen
Oily appearance predisposing the individual to acne

41
Q

Adolecents - Course

A

Coarse terminal hair appears in the axillae and pubic areas of both female and male adolescents, and on the face of males.

42
Q

Pregnancy - Increased blood

A

Increased blood flow to skin, especially that of the hands and feet, results from peripheral vasodilation and increased numbers of capillaries.

43
Q

Pregnancy - Accerleration of

A

Acceleration of sweat and sebaceous gland activity occurs.

44
Q

Pregnancy Spider

A

Spider angiomas and cherry hemangiomas that are present may increase in size

45
Q

Pregnancy Skin does what

A

Skin thickens; fat is deposited in subdermal layers.

Skin stretching, increased pigmentation, nevi changes

46
Q

Older Adults - Sebaceous and sweat

A

Sebaceous and sweat gland activity decreases: results in dry skin and less perspiration.

47
Q

Older Adults - Epidermis

A

Epidermis thins and fragility increases

48
Q

Older Adults - Loss of Collagen

A

Loss of collagen and decreasing elasticity causes wrinkles.

49
Q

Older Adults - Subcutaneous

A

Subcutaneous tissue decreases.

50
Q

Older Adults Gray hear

A

Gray hair from decreased melanocytes occurs

51
Q

Older Adults - Scalp

A

Scalp and body hair decrease; baldness

52
Q

Older Adults - Facial

A

Facial hair develops in women.

53
Q

Older Adults Nail growth

A

slows

NURS 5200 Holistic Health Assessment & Therapeutics for the Advanced Practice Nurse (12 decks)

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