Health assessment on skin examination

1. HEALTH ASSESSMENT
SKIN EXAMINATION
PREPARED BY:
USHA RANI KANDULA,
ASSISTANT PROFESSOR,
DEPARTMENT OF ADULT HEALTH NURSING,
ARSI UNIVERSITY, ASELLA, ETHIOPIA,
EAST AFRICA.

2. SKIN COLOR
-Skin color varies according to age
and race, although each person’s
skin color is fairly uniform.

3. -Exposed areas, such as the hands, face, and
neck, are often darker than unexposed areas,
-whereas the palms, soles, and nail beds are
lighter than the rest of the skin.

4. SKIN CHARACTERISTICS
-As does color,
the temperature, texture, and turgor of the
skin offer clues to the client’s health status.

5. -Although it is not technically a skin
characteristic,
you should also check for edema while you
are assessing the skin.

6. -Skin Temperature Use the dorsum of the
hand or fingers to assess skin temperature.

7. -Compare the temperature of the hands with
that of the feet,
and compare the right side of the body with the
left.

8. -The skin should feel warm, but keep in mind that
the temperature should be consistent with the
room temperature and the patient’s activity level.

9. -Be sure to check the temperature of the skin
over any area of erythema.

10. -When accompanied by warmth, erythema may
indicate infection or inflammatory changes.

11. -If the patient’s skin feels excessively warm,
validate your data:
Check her temperature to determine whether she
has a fever.

12. -Hyperthyroidism stimulates the metabolism and
may also elevate skin temperature.

13. -Excessive coolness may be due to
Poor peripheral circulation,
Shock,
Exposure to cold, or hypothyroidism.

14. SKIN MOISTURE
Normally the skin is warm and dry.
Excessive moisture may result from
hyperthermia,
thyroid hyperactivity,
anxiety, or hyperhidrosis (excessive sweating).

15. Oily skin is often seen with acne.
Dry skin may result from
Dehydration,
Chronic renal failure,
Hypothyroidism,
Excessive exposure, or overzealous hygiene.

16. SKIN TEXTURE
-Normal skin is smooth and soft.
The following factors affect skin texture:

17. ■ EXPOSURE.
-Exposed areas tend to be drier and
coarser(rough texture) in texture, as do the
elbows and knees.

18. ■ AGE.
-The skin of infants and young children is very
smooth because of lack of exposure to the
environment.

19. -IMPAIRED CIRCULATION.
Peripheral arterial insufficiency is associated
with
smooth,
thin,
shiny skin with little to no hair.

20. SKIN TURGOR
-Skin Turgor refers to the elasticity of the skin,
which provides data about hydration status.

21. -Poor turgor, or tenting (skin that tends to stay
pinched for a few seconds), may be a sigh of
dehydration.

22. ELASTICITY
-Decreases with age, so tenting may also
be seen with normal aging.

23. EDEMA
-Edema or scleroderma creates tension in
the tissues preventing the skin from being
pinched up.

24. EDEMA
-Edema, an excessive amount of fluid in the
tissues, is an abnormal finding.

25. -It is common in clients with
congestive heart failure,
kidney disease,
peripheral vascular disease, or low albumin
levels.

26. -A client with edema may tell you his skin feels
“tight” or say, “My shoes don’t fit any more.”
Swollen tissue may feel tender to the touch.

27. -Edema is not actually a condition of the skin,
but it is convenient to assess for it while assessing the
skin.

28. SKIN LESIONS
-Any lesion, variation in pigment, or break in
continuous tissue requires assessment.

29. -Lesions considered to be normal
variations and not harmful include:

30. MILIA.
-White raised areas on the nose, chin, and forehead
of newborns.

31. -These lesions, which resemble “whiteheads,”
are due to retention of sebum in the maturing
sebaceous glands.
-They disappear during infancy.

32. -Nevi (moles), freckles, birthmarks.
■ Skin tags.
Tiny tags or buds of skin usually around skin
creases, in middle and older adults.

33. STRIAE.
-Silver-to-pink “stretch marks” in pregnant women,
women who have had children,
and anyone who has experienced significant weight
fluctuations.

34. STRIAE IN LOWER ABDOMEN

35. -Abnormal lesions are classified as primary or
secondary.
■ Primary skin lesions.
Develop as a result of disease or irritation.
The pustules of acne are an example.

36. ■ SECONDARY SKIN LESIONS.
-It Develop from primary lesions as a result of
continued illness, exposure,
injury,or infection from ruptured pustules.

37. When you observe a lesion, evaluate it for--
size,
shape,
pattern,
color,
distribution,

38. Con----
Texture,
Surface relationship,
Exudate,
 Tenderness,
Pain, or
Itching.

39. Evaluate all skin lesions for the possibility of
malignancy (cancer),
Examine skin those located in a site exposed to
chronic rubbing or other trauma.

40. Ask the client whether he has any newly developed
moles or skin lesions or
Any change in the appearance of existing lesions.

41. WARNING SIGNS OF MALIGNANT
LESIONS
Asymmetry
Border irregularity,
Color variation,
Diameter greater than 0.5 cm
Elevation above the skin surface.

42. THANKING YOU