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Integumentary System > Physical Assessment > Flashcards

Physical Assessment Flashcards

1
Q

What is a normal assessment of the skin?

A
  1. Evenly pigmented
  2. No petechiae, purpura, lesions or excoriation
  3. Warm, dry, intact, elastic turgor
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2
Q

What is a normal assessment of the nails?

A
  1. Pink, oval, and adhere to the nail bed
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3
Q

What is a normal assessment of the hair?

A
  1. Shiny and full
  2. Amount of distribution appropriate for age and gender
  3. No flaking of scalp or forehead
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4
Q

What is the subjective data for a general assessment during the interview process?

A
  1. PMH
  2. Medications
  3. Allergies
  4. Surgery
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5
Q

What is the subjective data for assessment of health practice?

A
  1. Hygiene
  2. Diet history
  3. Elimination
  4. Exercise/Activity
  5. Sleep/rest
  6. Self-concept
  7. Values/belief system
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6
Q

What subjective data is assessed for medications used and drug reactions?

A
  1. OTC, prescribed or homeopathic
  2. Past reactions to meds
  3. Photosensitive drugs
  4. Side effects of steroids
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7
Q

What are some photosensitive drugs?

A
  1. Sulfa
  2. Diuretics
  3. Tetracycline
  4. Doxycycline
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8
Q

What are some side effects of steroids relating to the integumentary system?

A
  1. Acne

2. Thinning of skin

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9
Q

What subjective data is important for assessment of allergies?

A
  1. Allergy - something that consistently happens when using the same antigen
  2. Irritation - unpredictable
  3. Fruits - pesticides
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10
Q

What is the main question to determine scabies outbreak?

A

Is the itching so uncomfortable it wakes you out of your sleep?

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11
Q

What is the most important factor of assessing skin?

A

Change is the most important factor

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12
Q

What does normal skin look like?

A

It depends on the melanin

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13
Q

What does pale skin look like?

A

Decreased amounts of Hgb

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14
Q

What does blue mean for skin assessment?

A

Inadequate tissue perfusion with oxygenated blood

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15
Q

Deep red

A

Over abundance of RBCs meaning polycythemia Vera, sunburn, fever, allergic reaction, emotions

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16
Q

When inspecting lesions what needs to be documented?

A 
Size
Location 
Color
Distribution 
Shape
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17
Q

When inspecting for odors of the skin what assessment needs to be documented?

A

Unusual smells
Yeast/ bacteria
Intertriginous areas

18
Q

What does intertriginous mean?

A

In between skin folds

19
Q

Where are common intertriginous areas located?

A

Axilla, perineal area/groin, under breast, abdominal folds, between digits

20
Q

How many inches at a time to we assess the hair?

A

1inch blocks

21
Q

What could felt cold skin indicate?

A

Shock, organ failure, septic

22
Q

How do we assess the temperature of a patients skin?

A

Using the back of the hand

23
Q

What is assessed about turgor?

A

Is it elastic, sluggish, inelastic, tenting

24
Q

What does skin turgor indicate?

A

Hydration status

25
Q

What do we assess relating to moisture of a patients skin?

A

Are they moist or dry. Keep dry.

26
Q

What do we assess for texture of the skin?

A

Is the skin smooth, firm, even, calluses (palms/soles) normal

27
Q

What areas do we use to assess dark skin?

A 
Lips
MM
Nail beds
Buttocks
Palms
Soles
28
Q

How can we determine a dark skin patient is cyanotic?

A

They are usually ashen or gray in the eyes, lips, MM, nail beds

29
Q

How can we determine a dark skin patient has eccchymosis/bruising?

A

It’s hard to tell unless they have lightly pigmented skin

30
Q

How can we tell a dark skin patient has erythema?

A

They will have a deeper brown or purple color and increased skin temp

31
Q

How can we tell a dark skin patient is jaundiced?

A

Yellow-green eyes

Sclera of the eyes, palms, and soles

32
Q

How can we tell a dark skin patient has Petechiae?

A

It is difficult to see but use the bucca mucosa and eyes

33
Q

How can we determine if a dark skin patient has rashes?

A

May need to palpate raised area

34
Q

What is normal about the nail pigment of a dark skin patient?

A

Dark linear streaks on nail plate (normal over 90% of dark skin)

35
Q

Disorders that directly affect skin color are?

A 
Activity 
UV exposure
Emotions 
Cigarette smoking 
Edema 
Respiratory and cv system 
Renal and hepatic function
36
Q

If the skin is not blanchable it means what?

A

Related to Sub Q or intradermal bleed

37
Q

What is linear?

A

Forming a line

Ex. Poison oak rash

38
Q

What is annular?

A 
Ring-like
Ex. Ringworm, iris-target lesion
Concentrated rings 
"Bulls eye" 
Ex. Erythema multiforme
39
Q

What is dermatomal?

A

Follows a nerve path

Ex. Shingles

40
Q

All biopsies need a what?

A

Consent signed

41
Q

When a lesion is draining what is normally done?

A

A culture is sent out

Integumentary System (5 decks)

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