Physical Assessment Flashcards
What is a normal assessment of the skin?
- Evenly pigmented
- No petechiae, purpura, lesions or excoriation
- Warm, dry, intact, elastic turgor
What is a normal assessment of the nails?
- Pink, oval, and adhere to the nail bed
What is a normal assessment of the hair?
- Shiny and full
- Amount of distribution appropriate for age and gender
- No flaking of scalp or forehead
What is the subjective data for a general assessment during the interview process?
- PMH
- Medications
- Allergies
- Surgery
What is the subjective data for assessment of health practice?
- Hygiene
- Diet history
- Elimination
- Exercise/Activity
- Sleep/rest
- Self-concept
- Values/belief system
What subjective data is assessed for medications used and drug reactions?
- OTC, prescribed or homeopathic
- Past reactions to meds
- Photosensitive drugs
- Side effects of steroids
What are some photosensitive drugs?
- Sulfa
- Diuretics
- Tetracycline
- Doxycycline
What are some side effects of steroids relating to the integumentary system?
- Acne
2. Thinning of skin
What subjective data is important for assessment of allergies?
- Allergy - something that consistently happens when using the same antigen
- Irritation - unpredictable
- Fruits - pesticides
What is the main question to determine scabies outbreak?
Is the itching so uncomfortable it wakes you out of your sleep?
What is the most important factor of assessing skin?
Change is the most important factor
What does normal skin look like?
It depends on the melanin
What does pale skin look like?
Decreased amounts of Hgb
What does blue mean for skin assessment?
Inadequate tissue perfusion with oxygenated blood
Deep red
Over abundance of RBCs meaning polycythemia Vera, sunburn, fever, allergic reaction, emotions
When inspecting lesions what needs to be documented?
Size Location Color Distribution Shape
When inspecting for odors of the skin what assessment needs to be documented?
Unusual smells
Yeast/ bacteria
Intertriginous areas
What does intertriginous mean?
In between skin folds
Where are common intertriginous areas located?
Axilla, perineal area/groin, under breast, abdominal folds, between digits
How many inches at a time to we assess the hair?
1inch blocks
What could felt cold skin indicate?
Shock, organ failure, septic
How do we assess the temperature of a patients skin?
Using the back of the hand
What is assessed about turgor?
Is it elastic, sluggish, inelastic, tenting
What does skin turgor indicate?
Hydration status
What do we assess relating to moisture of a patients skin?
Are they moist or dry. Keep dry.
What do we assess for texture of the skin?
Is the skin smooth, firm, even, calluses (palms/soles) normal
What areas do we use to assess dark skin?
Lips MM Nail beds Buttocks Palms Soles
How can we determine a dark skin patient is cyanotic?
They are usually ashen or gray in the eyes, lips, MM, nail beds
How can we determine a dark skin patient has eccchymosis/bruising?
It’s hard to tell unless they have lightly pigmented skin
How can we tell a dark skin patient has erythema?
They will have a deeper brown or purple color and increased skin temp
How can we tell a dark skin patient is jaundiced?
Yellow-green eyes
Sclera of the eyes, palms, and soles
How can we tell a dark skin patient has Petechiae?
It is difficult to see but use the bucca mucosa and eyes
How can we determine if a dark skin patient has rashes?
May need to palpate raised area
What is normal about the nail pigment of a dark skin patient?
Dark linear streaks on nail plate (normal over 90% of dark skin)
Disorders that directly affect skin color are?
Activity UV exposure Emotions Cigarette smoking Edema Respiratory and cv system Renal and hepatic function
If the skin is not blanchable it means what?
Related to Sub Q or intradermal bleed
What is linear?
Forming a line
Ex. Poison oak rash
What is annular?
Ring-like Ex. Ringworm, iris-target lesion Concentrated rings "Bulls eye" Ex. Erythema multiforme
What is dermatomal?
Follows a nerve path
Ex. Shingles
All biopsies need a what?
Consent signed
When a lesion is draining what is normally done?
A culture is sent out
