Health Assessment mid-term: skin, hair, nails

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jam110007
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205259
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Health Assessment mid-term: skin, hair, nails
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2013-03-06 16:21:18
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Health Assessment mid term skin hair nails
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Health Assessment mid-term: skin, hair, nails
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  1. largest organ system is?
    the skin
  2. skin's function?
    • - protects internal structures
    • - protects against heat/ultra violet rays 
    • - barriers to microorganisms 
    • - absorption of medication
    • - sensory perception
    • - synthesizes vit.D repair surface wounds
    • - stores blood and fats
    • - identification of individuals
    • - communicate emotions
  3. what type of information can we get by just assessing the skin?
    • - general health
    • - presence of infection, fluid imbalance, and electrolyte imbalance 
    • - tissue perfusion/oxygenation status 
    • - activity, sleep/rest
    • - self-care ability 
    • - systemic disease manifestation
  4. structures of the skin
    • - epidermis
    • - dermis
    • - subcutaneous tissue
  5. skin: epidermis layer
    - outer, highly differentiated, avascular
  6. skin: dermis layer
    - inner, supportive, vascular layer
  7. skin: subcutaneous tissue
    layer of adipose tissue
  8. structure of epidermal appendages
    • - nails
    • - hair
    • - sensory fibers
    • - sebaceous glands
  9. nails are what?
    they are karatinized appendages of the epidermis
  10. hair consists of
    • - vellus: non pigmented, fine 
    • - terminal: is pigmented thick
  11. secaceous glands function?
    lubricates the skin
  12. sebaceous glands consists of what two categories?
    • - eccrine
    • - apocrine
  13. apocrine
    are found in the axila and genital areas - responsible for body odor
  14. functions of the glands
    • - excrete metabolic waste
    • - regulate temperature through evaporation 
    • - softening/ lubricating 
    • - resist water loss in low humidity
  15. skin health history: subjective data
    • - previous skin disease
    • - change in skin color or pigmentation 
    • - change in a mole
    • - change in feel of your skin - temperature, moisture, texture, excess, dryness 
    • - itching - pruritis
    • - excess bruising 
    • - rash or lesion
    • - medication 
    • - hair loss
    • - change in nails
    • - environmental or occupational hazards
  16. inspection: skin color
    • - caries from person to person 
    • - ask the person about their usual skin coloring 
    • - dependent on race
    • - exposed vs. non exposed skin
  17. cyanosis
    blue coloring of the skin
  18. jaundice
    yellow coloring of the skin
  19. pallor
    • paleness to the skin 
    • - due to anemia, blood loss, not producing enough cells from the bones
  20. erythema
    • redness of the skin 
    • - reflect usually an inflammatory disorder
  21. ecchymosis
    any type of bruising
  22. vitiligo
    • - complete absence of melanin 
    • - patchy areas
    • - occurs in all races
    • - auto immune disease 
    • - hypopituitary 
    • - body image disturbance
  23. hypopituitary
    lack of melanocytic stimulating hormone
  24. albinism
    • - total body depigmentation 
    • - congenital 
    • - easily sunburned 
    • - increased risk for skin cancer
  25. hyperpigmentation of skin
    • - sun exposure - tan lines
    • - overproduction of melanocytic stimulating hormone form
    • - renal disease 
    • - birthmark - pink/purple markings
  26. types of lesions
    • - discrete
    • - confluent
    • - annular
    • - generalized 
    • - grouped 
    • - linear
    • - target 
    • - zosterform
  27. discrete lesion
    separate and discrete
  28. generalized lesion
    want to identify where is it located
  29. linear lesions
    follows a track or a line
  30. target lesions
    can be referred to as the bulls eye rash
  31. zosterform lesion
    follows a nerve path and is extremely painful
  32. confluent region
    lesions merge and run together
  33. grouped lesions
    lesions are clustered together
  34. annular lesion
    lesions are arranged in a circular pattern
  35. macules and patches
    • flat lesions with change of pigmentation 
    • - freckles
  36. papules and plaque
    solid, elevated lesion, benign, get biopsy if shape/color/boarders change
  37. blisters
    sharply delineated elevation filled with clear fluid
  38. pustules and abscess
    • vesicles or bullae filled with puss
    • - acne
  39. nodules and tumor
    elevated lesions under the skin
  40. wheal
    • localized swelling in epidermis, irregular elevation, red or pale 
    • - hives
  41. scales
    • patchy, flaking of skin surface 
    • - dandruff
  42. crust
    dried serum, blood or pus on surface of skin
  43. lichenification
    layer of skin becomes thickened and rough as as result of rubbing
  44. erosion
    • superficial wound with loss of the epidermis or mucosa 
    • - risk of infection
  45. vascular lesions
    • - capillary hemangiomas
    • - ecchymosis
    • - purpura 
    • - petechiae
    • - spider anagioma
    • - venous star
  46. spider angioma
    • - hormonal contraceptives 
    • - pregnancy 
    • - liver disease
  47. venous star
    - engorgement of veins
  48. changes in skin with aging
    • - decreased skin elasticity, increased wrinkling 
    • - skin thinner, drier, more fragile
    • - decreased sweat gland activity 
    • - fewer hair follicles 
    • - decreased vascularity in dermis (pale)
    • - medication based skin changes
    • -seborrheic karatosis
    • - skin tags
    • - senile lentigo
    • - cherry angiomoas
  49. seborrheic karatosis
    • thick, leathery, waxy, lesion 
    • - occurs with aging
  50. danger signs in pigmented lesions of the skin
    • A- asymmetry
    • B- border irregular
    • C- color varied
    • D- diameter larger than 6 mm
    • E- elevation 
  51. basal cell carcinoma
    • - waxy translucent appearance 
    • - sharply defined border 
    • - not dangerous
  52. squamous cell carcinoma
    • rough, irregular, elevated
    • - does not matastize
  53. malignant melanoma
    • uneven surface, irregular outline, varying pigmentation 
    • - can metastasizes throughout the body
  54. findings when palpating skin
    • - moisture: dry, diaphoretic 
    • - temperature: warm bilaterally 
    • - no tenderness 
    • - texture: smooth, even, firm
  55. moisture of the skin is influenced by what?
    by environment, muscular activity, body temp, stress
  56. palpation: skin turgor
    • is a hydration test 
    • - not a fair assessment for older adults b/c their skin loses elasticity 
    • - in order to fairly assess an older person you have to do the test on the core of their body
  57. edema
    fluid build-up in intercellular spaces
  58. how do you measure edema?
    • - 0 = no pitting 
    • - +1 = 0 - 1/4" (mild)
    • - +2 = 1/4" - 1/2" (moderate)
    • - +3 = 1/2" - 1" (severe)
    • - +4 = >1" (severe)
  59. hair components
    • - color: loss of color with aging 
    • - distribution
    • - texture: should be shiny and smooth, resilient, should not be brittle 
    • - cleanliness
  60. alopecia
    • hair loss 
    • - male pattern baldness 
    • - drug/radiation
    • - trichotillomania
    • - cosmetic (hot comb) alopecia
    • - traction alopecia
  61. Trichotillomania
    • loss of hair (any type of hair on they body) by manually pulling it out
    • - can cause superficial infections
    • - makes you wonder what are they avoiding with doing this action
  62. female baldness
    • - hormonal imbalance
    • - stress/anxiety
    • - vitamin deficiencies 
    • - interaction with a medication
  63. hirsutism
    • excess hair
    • - drug induced 
    • - over production of adrenal glands
    • - hormonal imbalance
  64. nails should be.....
    should be pink, adherent to the nail bed itself, smooth, and flat
  65. nail bed profusion should reflect what?
    cardiovascular profusion
  66. normal variant in African American nails
    - pigmented bands
  67. infant/children nail growth rate?
    • rapid - every 6-8 weeks
    • - softer
  68. adult nail growth rate
    12-16 weeks
  69. elderly nail growth rate
    • 26-32 weeks
    • - thicker
  70. beau's lines
    • - transverse growth arrest lines 
    • - generalized serious illness
  71. what can cause a nail to stop growing
    if the patient have suffered a severe illness
  72. clubbing
    • reflects cardiovascular and pulmonary or GI processes
    • - distal finger becomes rounded - drumstick 
    • - nail angle 180
    • -
  73. onychomycosis
    • - fungal infection of the nail bed
    • - common in toenails
    • - dark, warm, moist environment 
    • - more common in people who have an underline diagnosis of diabetes

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