THE SKINMaria Carmela L. Domocmat, RN, MSN
STEP 1 Maria Carmela L. Domocmat, RN, MSN
STEP 2Confirm that theskin is clean and free frombody odor.    Maria Carmela L. Domocmat, RN, MSN
STEP 3  Cyanosis                                 Carotenemia                     Jaundice      Maria Carmela L. Domocmat, ...
Inspecting the                                      palms is an                                      opportunity to       ...
STEP 4Inspect the skin for evenpigmentation over the body.    Maria Carmela L. Domocmat, RN, MSN
Freckles                                     Versicolor                                NevusVitiligo                      ...
STEP 5Determinethe Client’sskintemperature    Maria Carmela L. Domocmat, RN, MSN
STEP 6Assess the amount of moisture on the skinsurface andtexture.    Maria Carmela L. Domocmat, RN, MSN
STEP 7Palpate to assess thicknessSTEP 8Palpating to assess skin elasticityand mobility.    Maria Carmela L. Domocmat, RN, ...
Assessing skin turgor                                      Testing for skin tenting                                       ...
STEP 9Palpate                                                 Edema of the                                                ...
STEP 10                               Spider AngiomaInspect theskin forsuperficial                                     Ven...
STEP 11    Inspect and palpate the skin for     lesion.ReferralSuspect physical abuse. Be especially                      ...
STEP 12Palpate the skin for sensitivity   Maria Carmela L. Domocmat, RN, MSN
Evaluating Skin LesionsA – (assymetrical)B – (borders)C – (color)D – ( diameter)E – (elevation)  Maria Carmela L. Domocmat...
PRIMARY LESIONSMACULE, PATCH                                                          Freckles                            ...
ChloasmaEcchymosis                             Mongolian                                         spot         Rubella     ...
Papule, Plaque                                              Lichen PlanusEczema                                           ...
PsoriasisMaria Carmela L. Domocmat, RN, MSN
Nodule, tumor                             Tumor                                           (café-au-lait spot)             ...
Vesicle, Bulla                         Atopic                         Dermatitis                                          ...
Erythema multiforme                 Bulla                                          Chicken Pox                            ...
WhealWheal in a drugeruption in aninfant                                         Urticaria    Maria Carmela L. Domocmat, R...
Pustule                                         Pustular psoriasis                                        FuruncleImpetigo...
AcneMaria Carmela L. Domocmat, RN, MSN
CystMaria Carmela L. Domocmat, RN, MSN
Secondary Skin Lesions Lichenification  Maria Carmela L. Domocmat, RN, MSN
Atrophy                                       Striae   Aged Skin  Maria Carmela L. Domocmat, RN, MSN
UlcerUlcer fromVenousStasis  Maria Carmela L. Domocmat, RN, MSN
Erosion                                      Apthous Ulcer Maria Carmela L. Domocmat, RN, MSN
FissureFissured Tongue                      Athlete’s FootMaria Carmela L. Domocmat, RN, MSN
Crust                                     Ruptured                                     vesicles                           ...
KeloidKeloid ofear piercing  Maria Carmela L. Domocmat, RN, MSN
Cancerous Skin Lesions                                  Nodule          Tumor      Telengiectasia                         ...
Cancerous Skin Lesions                               Nodule              Tumor                  UlerTelengiectasia       M...
Kaposi’sSarcoma Maria Carmela L. Domocmat, RN, MSN
Malignant                              Superficial SpreadingMelanoma                                       Nodular Serious...
Common Skin Variationsin Older Clients             Cutaneous Tags    Maria Carmela L. Domocmat, RN, MSN
Cherry Angiomas                                         Cutaneous HornSenile Lentigines    Maria Carmela L. Domocmat, RN, ...
Hair AssessmentMaria Carmela L. Domocmat, RN, MSN
Inspect the scalp and hairSTEP 1Confirm that the scalp and hair are clean.Examine strands of hair that are loose or undone...
STEP 2                                       STEP 3Observe the client’s                          Assess the texturehair co...
STEP 4                                 Male Pattern Balding > Observe theamount anddistribution ofthe hairthroughout thesc...
STEP 5Inspect the                     Regions of infection will                                fluoresce when exposedscalp...
Palpation of Hair1. Palpate the hair between your   fingertips.2. Note the condition of the hair   form the scalp to the e...
Abnormalities ofHair and Scalp                                       Pediculosis                                       Cap...
Hirsutism                -excess body hair in females, following                          the male pattern. Typically due ...
Alopecia Areata  Maria Carmela L. Domocmat, RN, MSN
Constant feature of                                     Kwashiorkor                                     but may also be se...
The ‘flag-sign’ or signa de                           bandera                           -alternating darker and lighter   ...
Tinea Capitis                                      Seborrheic Dermatitis Maria Carmela L. Domocmat, RN, MSN
Lanugo hairSymptoms of Scurvy-hairs on most parts of the bodybecome corksrew-shaped        Maria Carmela L. Domocmat, RN, ...
Sparse and brittle hair                    Menke’s kinky hairin this sex-linked                         syndromedisorderca...
AssessingtheNails Maria Carmela L. Domocmat, RN, MSN
STEP 1Inspect nail grooming and cleanliness STEP 2Inspect nail color and markings.    Maria Carmela L. Domocmat, RN, MSN
STEP 3Assess capillary refill    Maria Carmela L. Domocmat, RN, MSN
STEP 4                                         Inspect and                                          palpate the           ...
Curvature of the normal nail                                     Clubbing of the nail                                     ...
STEP 5Palpate the nails to determinethickness, regularity, andattachment to the nail bed.STEP 6Inspect and palpate the cut...
Common Nail Disorders                Clubbing of the finger In clubbing, the distal phalanx of each finger is rounded  and...
Paronychia   Maria Carmela L. Domocmat, RN, MSN
ONYCHOLYSIS                                        With Hyperkeratosis   Maria Carmela L. Domocmat, RN, MSN
Beau’s Lines Are transverse depressions in the nails associated   with acute severe illness. The lines emerge from under  ...
Terry’s                                       NailsMostly whitish with a distal band of reddish brownLunulae may not be vi...
Transverse White Lines(Mees’’Lines)              Curves are similar to those of the                         lunula, not th...
Onycho-                     Psoriasis         Subungal Hematomacryptosis                              Eggshell Nail       ...
Onychauxis                 Leukonychia   OnychatrophiaOnychophagy              Onychorrhexis     Pteryigium    Maria Carme...
Palpation of the Hair                                       Texture                                     Inspection of the ...
2 integumentary system
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nursing, health, assessment, carmela domocmat, integumentary system, skin, hair, nails

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2 integumentary system

  1. 1. THE SKINMaria Carmela L. Domocmat, RN, MSN
  2. 2. STEP 1 Maria Carmela L. Domocmat, RN, MSN
  3. 3. STEP 2Confirm that theskin is clean and free frombody odor. Maria Carmela L. Domocmat, RN, MSN
  4. 4. STEP 3 Cyanosis Carotenemia Jaundice Maria Carmela L. Domocmat, RN, MSN
  5. 5. Inspecting the palms is an opportunity to assess overall coloration.Maria Carmela L. Domocmat, RN, MSN
  6. 6. STEP 4Inspect the skin for evenpigmentation over the body. Maria Carmela L. Domocmat, RN, MSN
  7. 7. Freckles Versicolor NevusVitiligo Vitiligo Maria Carmela L. Domocmat, RN, MSN
  8. 8. STEP 5Determinethe Client’sskintemperature Maria Carmela L. Domocmat, RN, MSN
  9. 9. STEP 6Assess the amount of moisture on the skinsurface andtexture. Maria Carmela L. Domocmat, RN, MSN
  10. 10. STEP 7Palpate to assess thicknessSTEP 8Palpating to assess skin elasticityand mobility. Maria Carmela L. Domocmat, RN, MSN
  11. 11. Assessing skin turgor Testing for skin tenting Tenting Maria Carmela L. Domocmat, RN, MSN
  12. 12. STEP 9Palpate Edema of the handtodetect Pitting Edemaedema Maria Carmela L. Domocmat, RN, MSN
  13. 13. STEP 10 Spider AngiomaInspect theskin forsuperficial Venous Star arteries and Spider Veinveins Maria Carmela L. Domocmat, RN, MSN
  14. 14. STEP 11 Inspect and palpate the skin for lesion.ReferralSuspect physical abuse. Be especially If you notice drainagesensitive if client is fearful and has a history from any lesion, putof previous injuries. Obtain medical assistance on gloves before proceeding with theand follow your states’ legal requirements to assessment.notify the police or local protective agency. Maria Carmela L. Domocmat, RN, MSN
  15. 15. STEP 12Palpate the skin for sensitivity Maria Carmela L. Domocmat, RN, MSN
  16. 16. Evaluating Skin LesionsA – (assymetrical)B – (borders)C – (color)D – ( diameter)E – (elevation) Maria Carmela L. Domocmat, RN, MSN
  17. 17. PRIMARY LESIONSMACULE, PATCH Freckles Nevus Vitiligo Petechiae Maria Carmela L. Domocmat, RN, MSN
  18. 18. ChloasmaEcchymosis Mongolian spot Rubella Purpura Maria Carmela L. Domocmat, RN, MSN
  19. 19. Papule, Plaque Lichen PlanusEczema Warts Maria Carmela L. Domocmat, RN, MSN
  20. 20. PsoriasisMaria Carmela L. Domocmat, RN, MSN
  21. 21. Nodule, tumor Tumor (café-au-lait spot) Nodule Patch A combination typical of neurofibromatosis Maria Carmela L. Domocmat, RN, MSN
  22. 22. Vesicle, Bulla Atopic Dermatitis Vesicle Maria Carmela L. Domocmat, RN, MSN
  23. 23. Erythema multiforme Bulla Chicken Pox Pemphigus Maria Carmela L. Domocmat, RN, MSN
  24. 24. WhealWheal in a drugeruption in aninfant Urticaria Maria Carmela L. Domocmat, RN, MSN
  25. 25. Pustule Pustular psoriasis FuruncleImpetigo Maria Carmela L. Domocmat, RN, MSN
  26. 26. AcneMaria Carmela L. Domocmat, RN, MSN
  27. 27. CystMaria Carmela L. Domocmat, RN, MSN
  28. 28. Secondary Skin Lesions Lichenification Maria Carmela L. Domocmat, RN, MSN
  29. 29. Atrophy Striae Aged Skin Maria Carmela L. Domocmat, RN, MSN
  30. 30. UlcerUlcer fromVenousStasis Maria Carmela L. Domocmat, RN, MSN
  31. 31. Erosion Apthous Ulcer Maria Carmela L. Domocmat, RN, MSN
  32. 32. FissureFissured Tongue Athlete’s FootMaria Carmela L. Domocmat, RN, MSN
  33. 33. Crust Ruptured vesicles of herpes simplexMaria Carmela L. Domocmat, RN, MSN
  34. 34. KeloidKeloid ofear piercing Maria Carmela L. Domocmat, RN, MSN
  35. 35. Cancerous Skin Lesions Nodule Tumor Telengiectasia Ulcer Maria Carmela L. Domocmat, RN, MSN
  36. 36. Cancerous Skin Lesions Nodule Tumor UlerTelengiectasia Maria Carmela L. Domocmat, RN, MSN
  37. 37. Kaposi’sSarcoma Maria Carmela L. Domocmat, RN, MSN
  38. 38. Malignant Superficial SpreadingMelanoma Nodular Serious Type of Skin Cancer Maria Carmela L. Domocmat, RN, MSN
  39. 39. Common Skin Variationsin Older Clients Cutaneous Tags Maria Carmela L. Domocmat, RN, MSN
  40. 40. Cherry Angiomas Cutaneous HornSenile Lentigines Maria Carmela L. Domocmat, RN, MSN
  41. 41. Hair AssessmentMaria Carmela L. Domocmat, RN, MSN
  42. 42. Inspect the scalp and hairSTEP 1Confirm that the scalp and hair are clean.Examine strands of hair that are loose or undone.Part and divide the hair at 1-inch intervals andobserve. Maria Carmela L. Domocmat, RN, MSN
  43. 43. STEP 2 STEP 3Observe the client’s Assess the texturehair color of the hair Varies according to Roll a few strands of hairthe level of melanin between your thumb andproduction forefinger. Graying is Hold a few strands of hairinfluenced by taut with one hand while yougenetics slide the thumb and forefinger Graying in patches of your other hand along themay indicate a length of the strand.nutritional deficiency. Maria Carmela L. Domocmat, RN, MSN
  44. 44. STEP 4 Male Pattern Balding > Observe theamount anddistribution ofthe hairthroughout thescalp – varies withage, sex, and overallhealth. Maria Carmela L. Domocmat, RN, MSN
  45. 45. STEP 5Inspect the Regions of infection will fluoresce when exposedscalp for to the ultraviolet light of a Wood’s lamp.lesions.Dim the room light and shine a Wood’s lamp on theclient’s scalp as you part the hair. Maria Carmela L. Domocmat, RN, MSN
  46. 46. Palpation of Hair1. Palpate the hair between your fingertips.2. Note the condition of the hair form the scalp to the end the hair. Maria Carmela L. Domocmat, RN, MSN
  47. 47. Abnormalities ofHair and Scalp Pediculosis Capitis (head lice) Maria Carmela L. Domocmat, RN, MSN
  48. 48. Hirsutism -excess body hair in females, following the male pattern. Typically due to endocrine or metabolic dysfunction, or idiopathic. Side-effect of Cyclosporin Maria Carmela L. Domocmat, RN, MSN
  49. 49. Alopecia Areata Maria Carmela L. Domocmat, RN, MSN
  50. 50. Constant feature of Kwashiorkor but may also be seen in Marasmus. Dry hair; lacks normal lustreMaria Carmela L. Domocmat, RN, MSN
  51. 51. The ‘flag-sign’ or signa de bandera -alternating darker and lighter bands when held up. TrichotillomaniaMaria Carmela L. Domocmat, RN, MSN
  52. 52. Tinea Capitis Seborrheic Dermatitis Maria Carmela L. Domocmat, RN, MSN
  53. 53. Lanugo hairSymptoms of Scurvy-hairs on most parts of the bodybecome corksrew-shaped Maria Carmela L. Domocmat, RN, MSN
  54. 54. Sparse and brittle hair Menke’s kinky hairin this sex-linked syndromedisordercaused by a defect inintestinal copperabsorption Maria Carmela L. Domocmat, RN, MSN
  55. 55. AssessingtheNails Maria Carmela L. Domocmat, RN, MSN
  56. 56. STEP 1Inspect nail grooming and cleanliness STEP 2Inspect nail color and markings. Maria Carmela L. Domocmat, RN, MSN
  57. 57. STEP 3Assess capillary refill Maria Carmela L. Domocmat, RN, MSN
  58. 58. STEP 4 Inspect and palpate the nails for shape and Schamroth Technique contour. Maria Carmela L. Domocmat, RN, MSN
  59. 59. Curvature of the normal nail Clubbing of the nail Spoon nailMaria Carmela L. Domocmat, RN, MSN
  60. 60. STEP 5Palpate the nails to determinethickness, regularity, andattachment to the nail bed.STEP 6Inspect and palpate the cuticles. Maria Carmela L. Domocmat, RN, MSN
  61. 61. Common Nail Disorders Clubbing of the finger In clubbing, the distal phalanx of each finger is rounded and bulbous. The nail plate is more convex, and the angle between the plate and the proximal nail fold increases to 180º or more. The proximal nail fold, when palpated, feels spongy or floating. Causes are many, including chronic hypoxia and lung cancer. Maria Carmela L. Domocmat, RN, MSN
  62. 62. Paronychia Maria Carmela L. Domocmat, RN, MSN
  63. 63. ONYCHOLYSIS With Hyperkeratosis Maria Carmela L. Domocmat, RN, MSN
  64. 64. Beau’s Lines Are transverse depressions in the nails associated with acute severe illness. The lines emerge from under the proximal nail folds weeks later and grow gradually out with the nails. Maria Carmela L. Domocmat, RN, MSN
  65. 65. Terry’s NailsMostly whitish with a distal band of reddish brownLunulae may not be visibleSeen with aging and people with chronic diseases * Liver Cirrhosis * Congestive Heart Failure * Non-Insulin-Dependent Diabetes Maria Carmela L. Domocmat, RN, MSN
  66. 66. Transverse White Lines(Mees’’Lines) Curves are similar to those of the lunula, not the cuticle, and may follow an acute or severe illness. Maria Carmela L. Domocmat, RN, MSN
  67. 67. Onycho- Psoriasis Subungal Hematomacryptosis Eggshell Nail OnychomycosisLongitudinalMelanonychia Maria Carmela L. Domocmat, RN, MSN
  68. 68. Onychauxis Leukonychia OnychatrophiaOnychophagy Onychorrhexis Pteryigium Maria Carmela L. Domocmat, RN, MSN
  69. 69. Palpation of the Hair Texture Inspection of the Nails Color Shape and Configuration Palpation of the Nails TextureMaria Carmela L. Domocmat, RN, MSN

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