Assessment of integumentry system
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This document provides guidance on conducting a full skin assessment. It outlines key steps to inspecting the skin, hair, and nails. For the skin, it describes examining skin characteristics like pigmentation, temperature, moisture, and lesions. Common skin conditions are also reviewed. Assessment of the hair involves inspecting the scalp, color, texture and amount of hair. Nail assessment focuses on cleanliness, color, shape, thickness and identifying abnormalities. Various diagnostic tests for skin conditions are also mentioned.
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Assessment of integumentry system
- 1. BY J. REXY JENITA MSc NURSING 1ST YEAR SRIHER (DU) 1
- 2. LL is a 19 year old male seen in clinic with a complaint of worsening prurities in school and sleep. Hitsory- He first complained of dry, itchy skin on the flexural areas of his arms and legs about 2 years ago. Symptoms are worse in winter. Father has asthma. P/E – Dry skin Erythema, dryness, lichenification noted in flexural areas of both arms and legs Increased scaling on legs noted 2
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- 7. Inspect the skin for even pigmentation over the body. 7
- 9. Determine the Client’s skin temperature 9
- 10. Assess the amount of moisture on the skin surface and texture. 10
- 11. Palpate to assess thickness STEP 8 Palpating to assess skin elasticity and mobility. 11
- 12. Assessing skin turgor Testing for skin tenting 12
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- 14. Inspect the skin for superficial vein and arteries. 14
- 15. Inspect and palpate the skin for lesion. Suspect physical abuse. Palpate the skin for sensitivity STEP 12 15
- 16. A – (assymetrical) B – (borders) C – (color) D – ( diameter) E – (elevation) 16
- 17. PATCH 17
- 19. Rubella Purpura Mongolian spot 19
- 20. Papule Plaque 20
- 22. Psoriasis 22
- 23. Vesicle - Bulla Atopic Dermatitis Vesicle 23
- 25. Bulla Chicken Pox 25
- 26. Pemphigus 26
- 27. Wheal in a drugeruption in an infant 27
- 28. Urticaria 28
- 30. Furuncle 30
- 31. Impetigo 31
- 32. Acne 32
- 33. Cyst 33
- 36. Aged Skin 36
- 37. Ulcer - Ulcer from Venous Stasis 37
- 39. Erosion 39
- 40. Fissure - Fissured Tongue 40
- 42. Crust Ruptured vesicles of herpes simplex 42
- 43. Keloid - Keloid of ear piercing 43
- 44. Cancerous Skin Lesions 44
- 48. Malignant Superficial Spreading 48
- 49. Melanoma Nodular Serious Type of Skin Cancer 49
- 50. Common Skin Variations in Older Clients Cutaneous Tags 50
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- 55. STEP 1: Confirm 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 and observe. 55
- 56. STEP 2 - Observe the client’s hair color - Varies according to the level of melanin production. Graying is influenced by genetics. Graying in patches may indicate nutritional deficiency. 56
- 57. STEP 3- Assess the texture of the hair - Roll a few strands of hair between your thumb and forefinger. Hold a few strands of hair by taut with one hand while you slide the thumb and forefinger of your other hand along the a length of the strand. 57
- 58. STEP 4 - Observe the amount and distribution of the hairthrough out the scalp – varies withage, sex, and overallhealth. Male Pattern Balding 58
- 59. STEP 5 - Inspect the scalp for lesions-Dim the room light and shine a Wood’s lamp on theclient’s scalp as you part the hair. Regions of infection will fluoresce when exposed to the ultraviolet light of a Wood’s lamp.. 59
- 60. Palpate the hair between your fingertips Note the condition of the hair form the scalp to the end the hair. 60
- 61. Pediculosis Capitis (head lice) 61
- 62. Hirsutism 62
- 64. Dry hair; lacks normal lustre Constant feature of Kwashiorkor but may also be seen in Marasmus. 64
- 65. The ‘flag-sign’ or signa de bandera - alternating darker and lighter bands when held up. 65
- 69. Lanugo hair 69
- 70. Symptoms of Scurvy-hairs on most parts of the bodybecome corksrew-shaped 70
- 71. Menke’s kinky hair – Sparse and brittle hair in this sex-linked syndrome disorder caused by a defect in intestinal copper absorption 71
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- 73. STEP 1 - Inspect nail grooming and cleanliness STEP 2 - Inspect nail color and markings STEP 3 - Assess capillary refill 73
- 74. STEP 4 - Inspect and palpate the nails for shape and contour. 74
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- 76. STEP 5 - Palpate the nails to determinethickness, regularity, and attachment to the nail bed. STEP 6 - Inspect and palpate the cuticles. 76
- 77. Clubbing of the finger- Causes are many, including chronic hypoxia and lung cancer. 77
- 78. Paronychia 78
- 79. ONYCHOLYSIS With Hyperkeratosis 79
- 80. 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. 80
- 81. Terry’s Nails - Mostly whitish with a distal band of reddish brown Lunulae may not be visible Seen with aging and people with chronic diseases Liver Cirrhosis Congestive Heart Failure Non-Insulin Dependent Diabetes 81
- 82. Transverse White Lines (Mees’’Lines) Curves are similar to those of the lunula, not the cuticle, and may follow an acute or severe illness. 82
- 85. Subungal Hematoma Eggshell Nail 85
- 89. Skin biopsy Skin scraping Gram staining of exudates Tranck test- Blister Bark ground microscopy- Syphilis Slit skin smear examination Patch test Others - Immunofluorescence 89
- 90. Serological tests- For collagen vascular diseases e.g. SLE, scleroderma & viral infections and STDs. Laboratory tests: CBC, ESR, Liver & kidney tests, Blood sugar ,urine & stool analysis Imaging procedures: U/S, X-Ray. 90
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