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Health Assessment > Skin, Hair, & Nails > Flashcards

Skin, Hair, & Nails Flashcards

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
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2
Q

How to check for melanoma

A

Use ABCDEF categories

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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
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4
Q

What is the most important thing to ask if a pt suspects a mole with melanoma?

A

Has this changed?

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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
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6
Q

What percentage of skin cancer cases is melanoma?

A

1%

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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

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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
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9
Q

What are most melanoma cases due to?

A

95% due to UV radiation

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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
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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?

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12
Q

What should you ask pt about change in pigmentation?

A

All over? Or Localized?

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13
Q

What should you ask patient about change in moles?

A

Ask about ABCDEF

Tender? Bleeding? Itching?

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14
Q

Medical term for excessive dryness (spelling?)

A

Xerosis

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15
Q

Medical term for excessive oil (spelling?)

A

Seborrhea

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16
Q

Medical term for excessive itching (spelling?)

A

Pruritus

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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?

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18
Q

What should you ask pt about medications, regarding skin?

A

Bruises? (Blood thinners)
Rashes?
Hyperpigmentation? (Some diabetes medications)

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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

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20
Q

Medical term for hair loss (spelling?)

A

Alopecia

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21
Q

What should you ask pt about hair loss?

A

Where at?
When did it start?
Is it diffuse?
Shape of W?

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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

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23
Q

What should you ask pt about change in nails?

A

Brittle?
Fissures?
Thickening? (Diabetes)
Color?

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24
Q

What should you at about self care?

A

Do they wear sunscreen?
Sit in the shade?
Look for changes in moles?

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25
Q

Emotions that can affect skin color

A

Fear, anger, embarassment

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26
Q

How does fear or anger affect skin color?

A

Peripheral vasoconstriction - false pallor

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27
Q

How does embarassment affect skin color?

A

Flushing in face and neck - false erythema

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28
Q

What environmental factors affect skin color?

A

Hot room
Cold room
Cigarette smoking

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29
Q

How does a hot room affect skin color?

A

Vasodilation - false erythema

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30
Q

How does a chilly room affect skin color?

A

Vasoconstriction - false pallor, coolness

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31
Q

How does cigarette smoking affect skin color?

A

Vasoconstriction - false pallor

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32
Q

Physical factors that affect skin color

A

Prolonged elevation
Dependent position
Immobilization, prolonged inactivity

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33
Q

How does prolonged elevation affect skin color?

A

Decreased arterial perfusion - pallor, coolness

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34
Q

How does dependent position affect skin color?

A

Venous pooling - redness, warmth, distended veins

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35
Q

How does immobilization or prolonged inactivity affect skin color?

A

Slowed circulation - pallor, coolness, pale nail beds, prolonged capillary filling time

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36
Q

What are we looking at when we are inspecting the color of skin?

A 
General pigmentation
Freckles
Moles
Birthmarks
Widespread color change
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37
Q

Medical term for pale (spelling?)

A

Pallor

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38
Q

Medical term for redness (spelling?)

A

Erythema

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39
Q

Medical term for blue (spelling?)

A

Cyanosis

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40
Q

Medical term for yellow skin (spelling?)

A

Jaundice

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41
Q

Medical term for green/frosty skin (spelling?)

A

Uremia

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42
Q

What is vitiligo?

A

Body stops producing melanin in some areas of skin

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43
Q

What should skin temperature feel like?

A

Should be warm

Temperature equal bilaterally

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44
Q

What does warm skin suggest?

A

Normal circulatory status

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45
Q

Factors we look at when inspecting and palpating skin

A 
Color
Temperature
Moisture
Texture
Thickness
Edema
Mobility and turgor
Vascularity or bruising
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46
Q

Medical term for excessively sweaty skin

A

Diaphoresis

47
Q

What do we look for regarding moisture of skin?

A

Diaphoresis (sweaty)

Dehydration

48
Q

What do we look for regarding texture of skin?

A

May change in some areas (elbows, eczema)

49
Q

What are we looking for regarding thickness of skin?

A

Note change in thickness that is unexpected

50
Q

What are some examples of why someone would have edema?

A
  • Congestive heart failure (CHF) - edema is expected finding, but not normal
  • Pregnancy - edema is normal
51
Q

How do you document edema?

A

Use (+) scale

Can be out of 3 or 4

52
Q

What is turgor used for?

A

To determine hydration of patient

53
Q

How do you test a patient’s turgor?

A

Pinch skin and let go (below clavicle)
If it stays tented > 1 second = dehydrated
If stays < 1 second = hydrated

54
Q

Which patients may have delayed skin turgor, even if they are hydrated?

A 
Elderly patients (skin is more loose)
Pts in shock
55
Q

How would you document for a pt with normal skin mobility and tugor?

A

Mobile

< 1 second

56
Q

What do you document regarding vascularity or bruising?

A

Document all bruises

Note shape, approximate size, and location

57
Q

What is dependent edema?

A

Edema in a part of body that hangs down

58
Q

What is pitting edema?

A

Edema that leaves an indention when pressed

59
Q

What factors do we look at during inspection of hair?

A

Color
Texture
Distribution
Lesions (on scalp)

60
Q

What determines color of hair?

A

Melanin production

61
Q

What do you document about texture of hair?

A

Fine, thick, curly, straight, oily, dry?

62
Q

What should you document aout texture of hair?

A

Thin, thick, male pattern, patchy?

63
Q

How do you detect lesions on scalp?

A

Look at scalp by dividing hair into sections

64
Q

What factors do we look at when inspecting nails?

A

Shape and contour
Consistency
Color
Capillary refill

65
Q

What nail contour is normal?

A

Inner edge of nail is 160 degrees

66
Q

What measurement indicates early clubbing of nails?

A

Inner edge of nail is 180 degrees

67
Q

How do you identify clubbing of nails?

A

Inner edge of nail bed angle is greater than 180 degrees

68
Q

What does clubbing of nails look like?

A

Inner edge of nail bed angle is greater than 180 degrees

Distal phalanx looks rounder, whiter, shiny

69
Q

What can clubbing nails indicate?

A

Chronic lung inflammation
Lung cancers
Heart defects

70
Q

What do we document about consistency of nails?

A

Firm?

Spongy/squishy?

71
Q

What should normal nails look like?

A

Smooth and regular
Firm base
Uniform thickness

72
Q

How do you determine capillary refill?

A
  • Depress nail edge to blanch, then release
  • Color return should be instant
  • If color return takes longer than 1-2 seconds = sluggish
73
Q

How should you document skin lesions?

A 
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
Q

What is paronychia?

A
  • Infection around nail
  • Can occur from biting nails or in those who perform “wet” work
  • Difficult to treat, often requires plastic surgery
75
Q

What is onychomycosis?

A
  • Slow persistant fungal infection in fingernails & more often in toe nails
  • Common in older adults
  • Fungus causes change in color, texture, and thickness
76
Q

Circular lesion, begins in center and spreads to periphery

77
Q

Lesions run together

78
Q

Distinct, individual lesions that remain separate

79
Q

Twisted, coiled spiral, snakelike lesions

80
Q

Lesion that is a scratch, streak, line, or stripe

81
Q

Lesion with linear arrangement along a unilateral nerve route

A

Zosteriform

82
Q

Clusters of lesions

83
Q

Concentric rings of color in lesions

84
Q

Annular leasions that grow together

A

Polycyclic

85
Q

Flat color change less than 1 cm.

86
Q

Raised thickening of epidermis

87
Q

Macule larger than 1 cm.

88
Q

Solid, elevated, hard or soft bump greater than 1 cm.

89
Q

Superficial, raised, transient, and red with slightly irregular shape from edema

90
Q

Wheal coalesce to form extensive reaction

A

Urticaria (hives)

91
Q

Contains free fluid, up to 1 cm., a “blister”

92
Q

Fluid filled, in a sack

93
Q

Vesicle greater than 1 cm.

94
Q

Filled with pus in a cavity

95
Q

Example of a macule

96
Q

Examples of a papule

97
Q

Examples of patches

A

Vitiligo

Measles rash

98
Q

Examples of plaques

A

Psoriasis

Lichen planus

99
Q

Examples of nodules

A

Xanthoma

Fibroma

100
Q

Examples of wheals

A

Mosquito bite

Allergic reaction

101
Q

Examples of vesicles

A

Herpes simplex
Chicken pox
Shingles

102
Q

Example of a cyst

A

Sebaceous cyst

103
Q

Examples of bullas

A

Friction blister

Burns

104
Q

Examples of pustules

A

Impetigo

Acne

105
Q

Debris on skin surface to check for

A

Crusts

Scales

106
Q

Cracks in skin

107
Q

Scooped out but shallow depression of skin

108
Q

Deeper depression, extending into dermis

109
Q

Self-inflicted abrasion (from intense scratching), superficial

A

Excoriations

110
Q

Healed skin lesion, replaced with connective tissue (collagen)

111
Q

Scar with resulting skin level depressed (loss of tissue)

A

Athrophic scar

112
Q

Thickening of skin due to prolonged, intense scratching

A

Lichenifications

113
Q

Excess scar tissue

114
Q

3 parts of nursing diagnosis

A

1 - Identify priority problem
2 - Etiology
3 - Symptoms / cues

Health Assessment (17 decks)

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