Skin, Hair, & Nails

Question 1

You can see a lot of ___ ___ via the patient’s skin

Answer 1

red flags

Question 2

Do NOT ____ the skin

Answer 2

overlook

Question 3

If you overlook the skin, you could possible miss many ____ ____ regarding what’s going on inside the body.

Answer 3

important clues

Question 4

What are the 3 skin clues?

Answer 4

Respiratory problems (circulatory & breathing)
Cardiac problems
Dehydration

Question 5

Respiratory Signs in Skin

Answer 5

Pallor or “pale” (typically notice in eyes)
Cyanosis (bluish discoloration)
Clubbing
Decreased capillary refill

Question 6

Blue or Purple discoloration

Answer 6

Cyanosis

Question 7

Where can cyanosis be seen?

Answer 7

Lips, nose, cheeks, ears, and oral mucous membranes (inside of mouth)

Question 8

Cyanosis is a late sign of what?

Answer 8

respiratory distress

Question 9

Is cyanosis always a reliable indicator?

Answer 9

No

Question 10

Why is cyanosis not always reliable?

Answer 10

Because some patients never turn blue if they are dead (mainly in anemic patient b/c they lack red blood cells)

Question 11

If hemoglobin is ___, it’ll be impossible for them to become cyanotic.

Answer 11

< 5

Question 12

Bulging of distal fingers and nail beds

Answer 12

Clubbing

Question 13

In clubbing, what do the nail beds feel like?

Answer 13

spongy (lots of abnormal movement)

Question 14

Clubbing can be associated with many diseases such as..?

Answer 14

pulmonary
cardiac
neoplasms

Question 15

Is it possible for clubbing to go away?

Answer 15

could possibly go back to normal if the issue going on can be fixed

Question 16

Normal Capillary Refill

Answer 16

Color should return within 2 seconds

Question 17

Decreased Capillary Refill

Answer 17

Sluggish return indicates respiratory or cardiac dysfunction

Question 18

Capillary Refill determines what?

Answer 18

the heart pumping blood back in

Question 19

Cardiac Signs

Answer 19

All the respiratory signs
Cool Temperature (peripheral tissue not being filled w/warm blood)
Diaphoresis (sweating)
Edema

Question 20

Fluid accumulation in the interstitial spaces of dependent areas (e.g., feet, ankles, sacrum)

Answer 20

Edema

Question 21

Edema can be a sign if the ___ isn’t working well

Answer 21

heart

Question 22

Procedure for checking for Edmea

Answer 22

Press firmly for 3-4 seconds on tibia or ankle malleolus & let go. If it dents or dips in, it is edema.

Question 23

Bilateral edema can indicate….?

Answer 23

heart or kidney failure

Question 24

Edema Scale:

What is 1+ ?

Answer 24

Mild Pitting

slight indentation; no perceptible swelling of the leg

Question 25

Edema Scale:

What is 2+?

Answer 25

Moderate Pitting

Indentation subsides rapidly

Question 26

Edema Scale:

What is 3+?

Answer 26

Deep Pitting
(Indentation remains for a short time; leg looks swollen)

Question 27

Edema Scale:

What is 4+?

Answer 27

Very Deep Pitting

Indentations lasts a long time; Leg is very swollen

Question 28

Dehydration Signs

Answer 28

Dry mucous membranes (dry mouth, dull)

Poor skin turgor (skin does not bounce back once pinched gently)

Question 29

What should the Mucous Membrane normally look like?

Answer 29

smooth and moist

Question 30

When assessing the mucous membrane, what should you assess?

Answer 30

the oral mucous membrane

Question 31

When assessing skin turgor, what should you do and where?

Answer 31

gently pinch under the clavicle

Question 32

Where should you assess skin turgor in infants?

Answer 32

the abdomen

Question 33

Normal skin turgor

Answer 33

skin should be mobile and return quickly when released

Question 34

Miscellaneous signs

Answer 34

Jaundice and Malignant Skin Lesions

Question 35

Yellowish Skin color

Answer 35

Jaundice

Question 36

Jaundice would be first noted on what parts of the body?

Answer 36

the hard and soft palate

sclera

Question 37

Jaundice is associated with what?

Answer 37

liver dysfunction and some blood disorders

Question 38

Would the patient be jaundice in one area of the body?

Answer 38

No, they would be jaundice in every area

Question 39

Malignant Skin Lesions

ABCDE

Answer 39

A - asymmetry (has to be perfectly symmetric)
B - border irregularity
C - color variation (one solid color)
D - Diameter > 6mm (want to be smaller than 6mm)
E - Elevation or evolution (if its growing or changing)