Skin Physical Assessment

Question 1

3 inspection

Answer 1

1. skin integrity
2. skin colouration
3. skin lesion

Question 2

Inspection: Skin integrity abnormal result

Answer 2

pressure injury:
1. reddness, intact skin
2. Open wound, partial skin thickness
3. skin loss
4. tissue loss
(Unstagable: eschar, dead tissue)

Question 3

Inspection: Skin colouration abnormal result

Answer 3

Rash, pallor, white patches, albinism, cyanosis

Question 4

Inspection: Skin colouration normal result

Answer 4

freckles, evenly coloured, suntanned area depended by sun exposure

Question 5

Inspection: Normal Skin integrity result

Answer 5

intact skin without redness

Question 6

Inspection: Skin lesion abnormal result

Answer 6

keloid, vesicle, papule, pustule, urticaria

Question 7

Inspection: skin lesion normal result

Answer 7

smooth skin without lesion
normal: birthmark, healed scar, freckles

Question 8

Inspection: Skin lesion procedure （for skin cancer）

Answer 8

ABCDE: asymmetry, broaders, colouration, diameter, evolve

Question 9

8 skin palpation

Answer 9

1. skin temperature
2. skin mobility; tugor
3. skin thickness
4. skin texture
5. edema
6. skin moisture
7. skin lesion

Question 10

Palpation: Skin lesion procedure

Answer 10

note for mobility, consistency, drainage, tenderness

Question 11

Palpation: Skin lesion abnormal result

Answer 11

fixed & tender: +/- cancer
tender: +/- infected lesion

Question 12

Palpation: Skin lesion normal result

Answer 12

no lesion palpated

Question 13

Palpation: Skin texture procedure

Answer 13

use the plam area of three middle fingers to palpate

Question 14

Palpation: Skin texture normal result

Answer 14

even & smooth skin

Question 15

Palpation: Skin texture abnormal result

Answer 15

rough & dry skin: =/- hypothyroidism

Question 16

Palpation: Skin thickness procedures

Answer 16

use fingers to assess

Question 17

Palpation: Skin thickness normal result

Answer 17

normally thin
(Callucus) thick & rough section with constant pressure

Question 18

Palpation: Skin thickness abnormal result

Answer 18

very thin: +/- steroid therapy

Question 19

Palpation: Skin moisture procedure

Answer 19

assess skin moisture esp skin folds, e.g. under the breast, groin, belly

Question 20

Palpation: Skin moisture abnormal result

Answer 20

1. increased moisture/ sweat: fever/ hyperthyroidism
2. Dry: dehydration
3. Clammy: shock/ hypotention

Question 21

Palpation: Skin moisture normal result

Answer 21

elderly: dryer skin (decreased skin sebum production)
No dryness/ scalping

Question 22

Palpation: Skin temperature procedure

Answer 22

feel dorsal area tmeperature

Question 23

Palpation: Skin temperature normal result

Answer 23

warm/ cold skin at cold environment

Question 24

Palpation: Skin temperature abnormal result

Answer 24

Cold: shock/ poor circulation
Very Warmth: fever/ hyperthyroidism

Question 25

Palpation: Skin mobility & turgor procedure

Answer 25

gently pinch skin

Question 26

Palpation: Skin mobility & turgor normal result

Answer 26

mobile with elasticity & quickly return to original shape
Eldery: decrease collagen > loss of skin turgor

Question 27

Palpation: Skin mobility & turgor abnormal result

Answer 27

decreased mobility: edem
decreased turgor: dehydration

Question 28

Palpation: what are Skin mobility & turgor

Answer 28

skin mobility: how easy to pinch skin
skin turgor: elasticity/ how quick skin return to original shape

Question 29

Palpation: skin edema procedure

Answer 29

use thumb to press down skin (areas: ankle, feet, tribial)

Question 30

Palpation: skin edema normal result

Answer 30

rebound after release pressure without indented

Question 31

Palpation: skin edema abnormal result

Answer 31

severity of pitting edema by depth of indentation: 1+ (2mm), 2+ (4mm), 3+ (6mm), 4+ (8mm)
Non-pitting edema: hypothyroidism