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NURB 3060 > Skin, Hair, & Nails > Flashcards

Skin, Hair, & Nails Flashcards

1
Q

functions of the skin

A
  • protection
  • prevents penetration
  • perception
  • temperature regulation
  • identification
  • communication
  • wound repair
  • absorption and excretion
  • production of vitamin D
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2
Q

changes in the aging adult

A
  • losing elasticity
  • sweat and sebaceous glands decreasing, skin becomes dry
  • decreased thermoregulation
  • vascular fragility increase
  • minor injury causes senile purpura (easy, benign bruising
  • sun exposure and cigarette smoking cause wrinkling
  • loss of subcutaneous can increase skin breakdown
  • graying due to loss of melanocytes
  • hair loss, nail changes, women get whiskers
  • self-esteem
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3
Q

common skin variations

A
  • freckles
  • vitiligo
  • striae
  • seborrheic keratosis (a warty or crusty pigmented lesion)
  • scar
  • mole
  • cutaneous tage
  • cutaneous horn
  • cherry angiomas
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4
Q

common skin conditions found in African Americans

A
  • Keloids
  • Post inflammatory hypo or hyperpigmentation
  • Pseudofollicultis-razor bumps or ingrown hair
  • Melasma-”mask of pregnancy”
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5
Q

common variations of pigmentation

A
  • freckles

- moles

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6
Q

moles

A

clumps of melanocytes, tan to brown

-6mm or less, symmetrical, smooth borders, single uniform pigmentation

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7
Q

junctional moles

A

-macular, only in children/adolescents

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8
Q

compound

A

-macular and papular (adolescent to adult)

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9
Q

why is it important to ask about medications when assessing skin

A
  • some can cause photosensitivity reaction if the skin is exposed to UV light
  • some may experience allergic reaction to specific drugs, creams, or ointments
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10
Q

why is it important to ask about nail changes when assessing nails

A

can be a sign of systemic disorders such as malnutrition or local irritation

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11
Q

signs of bacterial infection in nails

A

green, black, or brown nail

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12
Q

signs of fungal infection in nails

A

yellow, thick, crumbling

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13
Q

yeast infection

A

white, separation of nail plate from nail bed

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14
Q

why is changing in sensation of skin important

A
  • may indicate vascular or neurologic problems such as peripheral neuropathy related to DM or arterial occlusive disease
  • can put patient at risk for developing pressure ulcers, impaired skin integrity, and skin infections
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15
Q

why is hair loss an important thing to assess

A

-it can be a sign of infection, stress, hypothyroidism, malabsorption syndromes, malnutrition, anorexia nervosa, and bulimia

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16
Q

how to assess irregular nevi

A 
-ABCDE
A: asymmetry
B: border irregularity
C: color variation
D: Diameter
E: elevation or evolution
-rapid changes, itching, burning, bleeding
-ugly duckling- does it look weird compared to other nevi
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17
Q

risk factors for melanoma

A
  • uv radiation
  • indoor tanning
  • white people 20 times more likely than African Americans, 5 times more likely in Hispanics
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18
Q

types of skin color changes

A
  • pallor
  • erythema
  • cyanosis
  • jaundice
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19
Q

pallor

A
  • white
  • oxygenated hemoglobin in blood are lost-ANEMIA
  • arterial insufficiency
  • shock (with shock-rapid pulse rate, oliguria, apprehension, and restlessness).
  • also caused from vasoconstriction from cold and smoking.
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20
Q

erythema

A
  • red
  • hyperemia in dilated capillaries.
  • Fever, local inflammation
  • emotional reactions (blushing)
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21
Q

cyanosis

A
  • blue
  • decreased perfusion or deoxygenated blood
  • best seen in lips, nose, cheeks, oral mucosa
  • occurs in shock, cardiac arrest, heart failure, chronic bronchitis, congenital heart disease
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22
Q

jaundice

A
  • yellow
  • Hemolytic disease of newborn
  • hepatitis
  • cirrhosis
  • sickle-cell disease
  • transfusion reactions. (caused by a rise in bilirubin in the body, clay colored stools and dark urine as well)
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23
Q

acanthosis nigricans

A
  • discoloration in body folds or creases

- think diabetes

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24
Q

how to assess for temperature

A
  • use the back of hands, checking bilaterally

- skin should be warm and equal bilaterally and suggest normal circulation

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25
Q

hypothermia

A
  • generalized coolness, local coolness can be expected with immobility or case
  • can occur in shock, cardiac arrest, arterial insufficiency, Raynaud disease
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26
Q

hyperthermia

A
  • increased metabolic rate such as in fever or heavy exercise
  • can be found with trauma, infection, or sunburn
  • can occur in hypothyroidism
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27
Q

moisture

A

-occurs naturally on face, hands, axillae, and skin folds

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28
Q

diaphoresis

A
  • sweating
  • due to high metabolic rate as in heavy activity, fever, warm environment, or anxiety
  • seen in thyrotoxicosis (thyroid storm), heart attack, anxiety, or pain
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29
Q

where is dehydration assessed and what are the signs

A
  • assessed in oral mucosa and skin turgor

- mucous membranes are dry, skin turgor tents, lips are parched, dry, crack skin

30
Q

assessing texture

A
  • should be smooth, firm, even
  • in hyperthyroidism skin feels soft like velvet
  • in hypothyroidism skin feels dry, rough, flaky
31
Q

assessing thickness

A
  • should be uniformly thin over most of the body
  • have callus areas on palms and soles
  • in arterial insufficiency skin is very thin and shiny
32
Q

assessing mobility and turgor

A
  • pinch skin fold on the anterior chest under the clavicle
  • mobility: skin should rise easily (decreased with edema)
  • turgor: skin ability return to place
  • slow turgor with dehydration and severe weight loss
33
Q

cherry anginomas

A
  • normal findings especially after 30
  • red and small
  • increase in size and frequency with age
34
Q

petechia

A

-round red or purple macule that is 1-2 mm in size

35
Q

hematoma

A

-localized collection of blood

36
Q

spider anginoma

A
  • red arteriole lesion with radiating branches

- seen in liver disease, pregnancy, vitamin B deficiency

37
Q

bruising

A
  • contusion
  • should be consistent with type of trauma
  • normally no venous dilations or varicosities
38
Q

stages of bruising

A
  1. red to blue- immediately or within first 24 hours
  2. blue to purple
  3. blue to green
  4. yellow
  5. brown to disappearing
39
Q

assessing lesions

A
  • color
  • elevation: flat, raise, or pedunculated
  • pattern or shape: angular, grouped, confluent, linear
  • size: measure in centimeters
  • location and distribution on body- generalized to any certain area
  • exudate: note color or odor
  • palpate and gently scrape any scaling or bleeding
  • primary or secondary
40
Q

circular lesions

A
  • begins in the center and spreads to periphery

- tinea corporis (ringworm)

41
Q

confluent lesion

A
  • run together

- urticaria (hives)

42
Q

discrete lesion

A
  • distinct lesions that remain separate

- skin tags, acne

43
Q

linear lesion

A

-scratch, streak, line, or stripe

44
Q

zosteriform lesion

A
  • linear arrangement along a unilateral nerve route

- herpes zoster

45
Q

grouped lesions

A
  • clusters

- vesicles or contact dermatitis

46
Q

primary lesions

A
  • macule
  • papule
  • patch
  • plaque
  • nodule
  • wheal
  • tumor
  • urticaria
  • cyst
  • pustule
47
Q

macule

A
  • less than 1 cm, flat

- freckles

48
Q

papules

A
  • less than 1 cm, raised

- mole or wart

49
Q

patch

A
  • larger than 1 cm

- vitiligo, cafe au lait spot, mongolian spot

50
Q

plaque

A
  • wider than 1 cm
  • coalesce to form elevation
  • psoriasis
51
Q

nodule

A
  • less than 1 cm
  • solid, elevated, hard or soft, may extend deeper into the dermis
  • fibroma
52
Q

wheal

A
  • superficial, raised, transient, erythematous, irregular shaped from edema
  • insect bite, allergic reaction
53
Q

tumor

A
  • larger than a few cm in diameter
  • firm or soft, benign or malignant
  • lipoma
54
Q

urticaria

A
  • lots of wheals together

- intensely pruritic

55
Q

cyst

A
  • encapsulated fluid-filled cavity in dermis or subcutaneous layer
  • sebaceous cyst
56
Q

pustule

A
  • turbid fluid fill
  • circumscribed and elevated
  • pimple or impetigo
57
Q

secondary skin lesions

A
  • crust
  • scale
  • fissure
  • erosion
  • ulcer
  • excoriation
  • scar
  • lichenification
58
Q

crust

A
  • dried exudate, color depends on fluid

- impetigo, scab

59
Q

scale

A

-compact desiccated flakes of skin, dry or greasy, silvery or white

60
Q

fissure

A
  • linear crack, abrupt edges, extends into dermis, dry or moist
  • cheilosis, athlete’s foot
61
Q

erosion

A

-scooped out shallow depression, epidermis loss, moist but no bleeding, no scar formation

62
Q

ulcer

A
  • deeper depression, extends into dermis and beyond, may bleed, leaves scar
  • pressure ulcer
63
Q

exoriation

A
  • can be self inflicted from intense itching

- insect bites, scabies, varicella

64
Q

scar

A
  • post repair of lesion-permanent fibrotic change after healing
  • surgery, injury, acne
65
Q

lichenification

A

-thickened skin from prolonged scratching

66
Q

nail abnormalities

A
  • thickened nails (may indicate poor circulation)
  • koilonychia (spoon shaped nails)
  • pitting (psoriasis)
  • yellow nail syndrome (respiratory/AIDS)
  • paronychia (infection around nail bed)
67
Q

mongolian spots

A
  • blue to black to purple macular area at sacrum, buttocks, sometimes abdomen, thighs, shoulder or arms
  • usually subside within 1 year
  • common in Black, Asian, American Indian, and Hispanic newborns
68
Q

cafe au lait spot

A
  • large round oval spot of light brown pigmentation
  • present at birth
  • normal variant
69
Q

braden scale scoring

A
  • determines pressure sore risk
  • 19-23 no risk
  • 15-18—preventative interventions needed
  • 13-14—Moderate risk
  • 10-12—High risk
  • 6-9—very high risk
70
Q

pressure injury risk areas

A
  • head
  • ear
  • shoulder
  • elbow
  • hip
  • sacrum
  • buttocks
  • knee (inner and outer side)
  • heel

NURB 3060 (3 decks)

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