Skin, Hair, & Nails Flashcards
(114 cards)
1
Q
Purpose / Function of the integumentary system
A
- Protection
- Prevents penetration
- Perception
- Temperature regulation
- Identification
- Communication
- Wound repair
- Absorption and excretion
- Production of Vitamin D
2
Q
How to check for melanoma
A
Use ABCDEF categories
3
Q
What are the ABCDEF categories?
A
Asymmetry Border irregularity Color variation Diameter > 6 mm (size of a pencil eraser) Evaluation or Evolution Funny looking
4
Q
What is the most important thing to ask if a pt suspects a mole with melanoma?
A
Has this changed?
5
Q
Additional symptoms that are warning signs of melanoma
A
- Rapidly changing lesion
- Itching, burning, or new onset bleeding of mole
- Color change of lesion to dark, black, or gray
6
Q
What percentage of skin cancer cases is melanoma?
A
1%
7
Q
How much more likely are white people to get melanoma compared to Hispanics and black people?
A
21 times higher than Hispanics
26 times higher than black people
8
Q
Based off gender, who is more likely to get melanoma?
A
- Before age 50, women more likely
- By 65 yrs, rates in men doubled than in women
- By 80 yrs, rates in men tripled than in women
9
Q
What are most melanoma cases due to?
A
95% due to UV radiation
10
Q
Subjective data regarding skin
A
- History of skin disease
- Change in pigmentation
- Change in mole
- Excessive dryness or moisture
- Pruritus
- Medications
- Excessive bruising
- Rash or lesion
- Hair loss
- Change in nails
- Environmental and occupational hazards
- Ask about self-care
11
Q
What should you ask pt about history of skin disease?
A
- Personal history of disease and how it was treated
- Allergic skin problems? Hives?
12
Q
What should you ask pt about change in pigmentation?
A
All over? Or Localized?
13
Q
What should you ask patient about change in moles?
A
Ask about ABCDEF
Tender? Bleeding? Itching?
14
Q
Medical term for excessive dryness (spelling?)
A
Xerosis
15
Q
Medical term for excessive oil (spelling?)
A
Seborrhea
16
Q
Medical term for excessive itching (spelling?)
A
Pruritus
17
Q
What should you ask patient about pruritus?
A
When did it start?
How long has it been going on?
Is it waking you up at night?
18
Q
What should you ask pt about medications, regarding skin?
A
Bruises? (Blood thinners)
Rashes?
Hyperpigmentation? (Some diabetes medications)
19
Q
What should you ask a pt about a rash or lesion?
A
Ask if they have been there for a long time / aren’t healing
20
Q
Medical term for hair loss (spelling?)
A
Alopecia
21
Q
What should you ask pt about hair loss?
A
Where at?
When did it start?
Is it diffuse?
Shape of W?
22
Q
What should you do if your pt is female and has hairloss?
A
Know that hairloss in women is not normal, it can be due to hormones or medications
23
Q
What should you ask pt about change in nails?
A
Brittle?
Fissures?
Thickening? (Diabetes)
Color?
24
Q
What should you at about self care?
A
Do they wear sunscreen?
Sit in the shade?
Look for changes in moles?
25
Emotions that can affect skin color
Fear, anger, embarassment
26
How does fear or anger affect skin color?
Peripheral vasoconstriction - false pallor
27
How does embarassment affect skin color?
Flushing in face and neck - false erythema
28
What environmental factors affect skin color?
Hot room
Cold room
Cigarette smoking
29
How does a hot room affect skin color?
Vasodilation - false erythema
30
How does a chilly room affect skin color?
Vasoconstriction - false pallor, coolness
31
How does cigarette smoking affect skin color?
Vasoconstriction - false pallor
32
Physical factors that affect skin color
Prolonged elevation
Dependent position
Immobilization, prolonged inactivity
33
How does prolonged elevation affect skin color?
Decreased arterial perfusion - pallor, coolness
34
How does dependent position affect skin color?
Venous pooling - redness, warmth, distended veins
35
How does immobilization or prolonged inactivity affect skin color?
Slowed circulation - pallor, coolness, pale nail beds, prolonged capillary filling time
36
What are we looking at when we are inspecting the color of skin?
```
General pigmentation
Freckles
Moles
Birthmarks
Widespread color change
```
37
Medical term for pale (spelling?)
Pallor
38
Medical term for redness (spelling?)
Erythema
39
Medical term for blue (spelling?)
Cyanosis
40
Medical term for yellow skin (spelling?)
Jaundice
41
Medical term for green/frosty skin (spelling?)
Uremia
42
What is vitiligo?
Body stops producing melanin in some areas of skin
43
What should skin temperature feel like?
Should be warm
| Temperature equal bilaterally
44
What does warm skin suggest?
Normal circulatory status
45
Factors we look at when inspecting and palpating skin
```
Color
Temperature
Moisture
Texture
Thickness
Edema
Mobility and turgor
Vascularity or bruising
```
46
Medical term for excessively sweaty skin
Diaphoresis
47
What do we look for regarding moisture of skin?
Diaphoresis (sweaty)
| Dehydration
48
What do we look for regarding texture of skin?
May change in some areas (elbows, eczema)
49
What are we looking for regarding thickness of skin?
Note change in thickness that is unexpected
50
What are some examples of why someone would have edema?
- Congestive heart failure (CHF) - edema is expected finding, but not normal
- Pregnancy - edema is normal
51
How do you document edema?
Use (+) scale
| Can be out of 3 or 4
52
What is turgor used for?
To determine hydration of patient
53
How do you test a patient’s turgor?
Pinch skin and let go (below clavicle)
If it stays tented > 1 second = dehydrated
If stays < 1 second = hydrated
54
Which patients may have delayed skin turgor, even if they are hydrated?
```
Elderly patients (skin is more loose)
Pts in shock
```
55
How would you document for a pt with normal skin mobility and tugor?
Mobile
| < 1 second
56
What do you document regarding vascularity or bruising?
Document all bruises
| Note shape, approximate size, and location
57
What is dependent edema?
Edema in a part of body that hangs down
58
What is pitting edema?
Edema that leaves an indention when pressed
59
What factors do we look at during inspection of hair?
Color
Texture
Distribution
Lesions (on scalp)
60
What determines color of hair?
Melanin production
61
What do you document about texture of hair?
Fine, thick, curly, straight, oily, dry?
62
What should you document aout texture of hair?
Thin, thick, male pattern, patchy?
63
How do you detect lesions on scalp?
Look at scalp by dividing hair into sections
64
What factors do we look at when inspecting nails?
Shape and contour
Consistency
Color
Capillary refill
65
What nail contour is normal?
Inner edge of nail is 160 degrees
66
What measurement indicates early clubbing of nails?
Inner edge of nail is 180 degrees
67
How do you identify clubbing of nails?
Inner edge of nail bed angle is greater than 180 degrees
68
What does clubbing of nails look like?
Inner edge of nail bed angle is greater than 180 degrees
| Distal phalanx looks rounder, whiter, shiny
69
What can clubbing nails indicate?
Chronic lung inflammation
Lung cancers
Heart defects
70
What do we document about consistency of nails?
Firm?
| Spongy/squishy?
71
What should normal nails look like?
Smooth and regular
Firm base
Uniform thickness
72
How do you determine capillary refill?
- Depress nail edge to blanch, then release
- Color return should be instant
- If color return takes longer than 1-2 seconds = sluggish
73
How should you document skin lesions?
```
Color
Elevation
Pattern or shape (grouping or distinctness of each lesion)
Size (in centimeters)
Location and distribution on body
Exudate (drainage color and/or odor)
```
74
What is paronychia?
- Infection around nail
- Can occur from biting nails or in those who perform “wet” work
- Difficult to treat, often requires plastic surgery
75
What is onychomycosis?
- Slow persistant fungal infection in fingernails & more often in toe nails
- Common in older adults
- Fungus causes change in color, texture, and thickness
76
Circular lesion, begins in center and spreads to periphery
Annular
77
Lesions run together
Confluent
78
Distinct, individual lesions that remain separate
Discrete
79
Twisted, coiled spiral, snakelike lesions
Gyrate
80
Lesion that is a scratch, streak, line, or stripe
Linear
81
Lesion with linear arrangement along a unilateral nerve route
Zosteriform
82
Clusters of lesions
Grouped
83
Concentric rings of color in lesions
Target
84
Annular leasions that grow together
Polycyclic
85
Flat color change less than 1 cm.
Macule
86
Raised thickening of epidermis
Papule
87
Macule larger than 1 cm.
Patch
88
Solid, elevated, hard or soft bump greater than 1 cm.
Nodule
89
Superficial, raised, transient, and red with slightly irregular shape from edema
Wheal
90
Wheal coalesce to form extensive reaction
Urticaria (hives)
91
Contains free fluid, up to 1 cm., a “blister”
Vesicle
92
Fluid filled, in a sack
Cyst
93
Vesicle greater than 1 cm.
Bulla
94
Filled with pus in a cavity
Pustule
95
Example of a macule
Freckle
96
Examples of a papule
Mole
| Wart
97
Examples of patches
Vitiligo
| Measles rash
98
Examples of plaques
Psoriasis
| Lichen planus
99
Examples of nodules
Xanthoma
| Fibroma
100
Examples of wheals
Mosquito bite
| Allergic reaction
101
Examples of vesicles
Herpes simplex
Chicken pox
Shingles
102
Example of a cyst
Sebaceous cyst
103
Examples of bullas
Friction blister
| Burns
104
Examples of pustules
Impetigo
| Acne
105
Debris on skin surface to check for
Crusts
| Scales
106
Cracks in skin
Fissures
107
Scooped out but shallow depression of skin
Erosion
108
Deeper depression, extending into dermis
Ulcer
109
Self-inflicted abrasion (from intense scratching), superficial
Excoriations
110
Healed skin lesion, replaced with connective tissue (collagen)
Scar
111
Scar with resulting skin level depressed (loss of tissue)
Athrophic scar
112
Thickening of skin due to prolonged, intense scratching
Lichenifications
113
Excess scar tissue
Keloid
114
3 parts of nursing diagnosis
1 - Identify priority problem
2 - Etiology
3 - Symptoms / cues
