N 295 lecture 3 skin student copy
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N 295 lecture 3 skin student copy N 295 lecture 3 skin student copy Presentation Transcript

  • Integumentary System: Assessing the SKIN Spring 2012
  • Functions of the Skin
    • Protects Against Trauma
    • Protects Against Ultraviolet Radiation
    • Support Structure
    • Maintains Body Temperature
    Spring 2012
  • Functions of Skin
    • Involved with Absorption and Excretion
    • Involved with Immunity
    • Synthesizes Vitamin D
    • Helps Maintain Fluid Balance
    • Provides Sensation with the External Environment
    Spring 2012
  • Structures of Skin
    • Epidermis
    • Dermis
    • Subcutaneous Tissue
    • Epidermal Appendages:
      • Hair
      • Nails
      • Sebaceous Glands
    Spring 2012
  • Risk Factors
    • . . . . . .
    • . . . . . .
    • . . . . . .
    • . . . . .
    • . . . . .
    Spring 2012
  • SECONDARY SKIN LESIONS
    • Crust *
    • Scale
    • Fissure
    • Erosion
    • Ulcer
    • Scar
    • Excoriation
    • Keloid
    • Lichenification
    Spring 2012
  • Descriptions of Lesions *
    • Size
    • Shape
    • Color
    • Texture
    • Surface relationship
    • Exudate
    • Tenderness or pain
    Spring 2012
  • Skin Assessment:
    • Approach
    • Inspection
    • Palpation
    Spring 2012
  • Examination
    • General Inspection :
      • General pigmentation
      • Texture
      • Temperature
      • Moisture
      • Mobility
      • Turgor
      • Vascularity or bruising
      • Edema
      • Lesions or discoloration
    Spring 2012
  • Adult
      • Normal Variations:
        • Striae
        • Vitiligo
        • Moles
        • Freckles
        • Birthmarks
    Spring 2012
  • Warning Signs of Cancer
    • A = Asymmetry
    • B = Boarder irregular
    • C = Color variation
    • D = Diameter >6mm
    • E = Elevation & Enlargement
    Spring 2012
  • Abnormal Skin Findings
    • Central Cyanosis
    • Peripheral Cyanosis
    • Pallor:
    • decreased Hgb-,
    • decreased perfusion
    • Also on conjunctiva and mucus membranes
    Spring 2012
  • Examination
    • Palpate skin for temp, moisture, mobility and turgor
    • Hair Distribution
    • Nail
      • Thickening or hypertrophy
      • Thinning or Brittleness
      • Spoon Shaped
      • Pitting of Nail
      • Pigmented Bands
      • Splinter Hemorrhages
    Spring 2012
  • Vascular Lesions:
    • Petechiae
    • Ecchymosis
    • Purpura
    • Hematoma
    • Venous Star
    • Telangiectasis
    • Spider Angioma
    • Erythema
    Spring 2012
  • Pitting Edema *
    • 1+ < 0.25 inch (4.32mm) depression
    • 2+ 0.25 - 0.5 inch (12.7mm)
    • 3+ 0.5 - 0.75 inch (19 mm)
    • 4+ 0.75 - 1 inch or more (25 mm)
    Spring 2012
  • Pitting Edema *
    • 1+ < 0.08 inch (2mm) depression __________
    • 2+ 0.16 inch (4mm) ___________
    • 3+ 0.24 inch (6 mm)
    • 4+ >0.32 inch (8 mm)
    Spring 2012
  • Aging Adult Health History
    • Increased Risk of Damage
    • Delayed Wound Healing
    • Pruritis
    • Skin Turgor
    • Lentigo (macule)
    • Cutaneous Tags
    • Cherry Angioma (red papule)
    • Seborrheic keratoses / Actinic keratoses
    Spring 2012
  • Older Adult
    • Approach:
    • Skin atrophies
    • Increase amount of pigmentation esp. in sun exposed areas
    • Isolated areas of hypo pigmentation
    • Skin becomes drier and flattens, often becoming paper like
    • Elasticity decreases and wrinkles develop
    Spring 2012
  • Older Adult
    • Decreased melanocyte function causes gray hair and pale skin
    • Decreased axillary, pubic & scalp hair
    • Women: facial hair
    • Men: nasal hair
    • Nails grow more slowly, become thicker & more brittle, yellowish
    Spring 2012
  • Older Adult
    • Temp/ moisture , mobility
      • Increased dryness (xerosis)
      • Thinning of the skin
      • Hanging skin
    • Hair:
      • Graying, thin texture
      • Symmetric balding may occur in men
    • Facial & Body hair
      • Men increased coarseness
    • Nail
      • Thickening, increases brittleness, deformity
    Spring 2012
  • Cultural Considerations
    • The oral mucosa is best for assessing color changes in dark-skinned persons
    • Assessing the sclera for jaundice, rather than the skin in Asians
    Spring 2012
  • Health Promotion
    • Immunizations
    • Sun Exposure & Protection
    • Skin Cancer
    • Teach client:
      • skin self assessment
      • Toenail trimming
      • Ingrown toenail care
    Spring 2012