Assessment of Skin, hair, and nails Flashcards
(136 cards)
1
Q
What is the largest organ of the body?
A
Skin
Note:
- It is our physical barrier that protects us from the underlying tissues and organs from microorganisms, physical trauma, ultraviolet radiation, and dehydration.
- It plays a vital role in temperature maintenance, fluid and electrolyte balance, absorption, excretion, sensation, immunity, and vitamin synthesis.
- Provides identity to a person’s appearance, like fingerprints and thumbmarks.
- The skin is thicker on the palms of the hands and soles of the feet and is continuous on the mucus membranes at the orifices of the body.
2
Q
The skin is composed of 3 Layers. What are these?
A
- Epidermis (Epidermal)
- Dermis (Dermal)
- Hypodermis (Subcutaneous Tissue)
3
Q
This is the outermost layer of the skin that is consist of dead, keratinized cells which renders the skin to be waterproof.
A
Epidermis (Epidermal)
4
Q
This is present on the epidermis hair, nails, dental enamel, and horny tissue composed of keratin.
A
Keratin
5
Q
Epidermal layer replaced every how many weeks?
A
3-4 weeks
6
Q
WHAT IS THIS?
- It undergoes cell division and contains melanin together with capillary blood flow, chromophores.
A
Stratum Spinosum and Basale
7
Q
WHAT IS THIS?
- Brown pigment
- Major Determinant of the Skin
A
Melanin
8
Q
This is the Inner layer of the skin. It contains elastic fibers, nerve endings, and lymph vessels. It is also the origin of sweat glands and hair follicle.
A
Dermis
9
Q
Dermis is visible in the hands and feet, and it creates the unique pattern of friction ridges commonly known as what?
A
Fingerprints
10
Q
No. of fingerprints?
A
Infinite
Note:
- NO 2 PEOPLE HAVE THE SAME FINGERPRINTS
11
Q
This is found in the dermis layer of the skin. It is attached to hair follicle and is present over most of the body.
A
Sebaceous glands
12
Q
The sebaceous glands secretes oil which is called __________.
This waterproofs the hair and skin.
A
Cebum
13
Q
What are the two types of sweat glands in the skin, both located in the dermis but with different functions?
A
Eccrin and Apocrine
14
Q
WHAT IS THIS?
- Found all over the body (entire skin), especially on the palms, soles, and forehead.
- Produce a clear, watery sweat primarily for thermoregulation (cooling the body).
- Open directly onto the skin surface.
- Active from birth.
A
Eccrine glands
15
Q
WHAT IS THIS?
- Found in hairy areas like the armpits, groin, and around the nipples.
- Secrete a thicker, milky fluid containing proteins and lipids.
- Open into hair follicles.
- Become active during puberty and are linked to body odor when bacteria break down the sweat.
A
Apocrine Glands
16
Q
WHAT IS THIS?
- This is a combination of sweat and skin bacteria.
A
Body Odor
17
Q
Apocrine is link to what?
A
Menstrual cycle
18
Q
This is the loose connective tissue that stores fat as an energy reserve, provides insulation to conserve internal body parts, and is a pathway for the nutrients and removal of waste products to and from the skin.
A
Subcutaneous tissue
19
Q
FAMILIARIZE ONLY!
“What are the Functions of the skin?”
A
- Protective barrier against invasion from environmental hazards & pathogens. (1st line of defense)
- Protection for underlying organs
- Temperature regulations / heat control / Vit D synthesis
- Sensory signals
- Organ of excretion for substances such as water, salts & nitrogenous wastes
- Indicator of nonverbal language & emotions via blushing & facial expression
- Purpose of identification via fingerprints & birthmarks
20
Q
Give 4 Functions of the Skin
(Notes ni ma’am sa slide)
A
- Protection from microorganisms
- Protection from trauma
- Protection from UVR (Ultraviolet rays)
- Protection from dehydration
21
Q
WHAT IS THIS?
- This is consist of keratinized layer found over much of the body, except for lips, nipples, soles of feet, palms of hand, labia minora, and penis.
A
Hair
22
Q
FAMILIARIZE ONLY!
“What are the Functions of the Hair?”
A
- Provides warmth, protection and sensation to the underlying systems
- Vellus hair enhances tactile sensation, thermoregulation
- Hair on the head protects the scalp
- Other hair (filter dust & other airborne debris)
- In other countries, status symbol of beauty and wealth
23
Q
What are the 2 Types of Hair found on the human body?
A
- Vellus Hair (Peach fuzz)
- Terminal Hair
Note:
OTHER HAIRS are
- Burnik - buhok sa pwet
- Tutsang - buhok sa ilong
24
Q
What type of hair is this?
- Fine, soft, and unpigmented (light-colored).
- Covers most of the body except for the lips, palms, and soles.
- Provides slight insulation and protection.
A
Vellus Hair (Peach Fuzz)
25
What type of hair is this?
* **Thicker, coarser, and darker.**
* **Found on the scalp, eyebrows, eyelashes, and, after puberty, in areas like the armpits and pubic region.**
* Influenced by hormones, especially androgens.
Terminal Hair
26
**Hair color** is determined by the **amount and type of pigment** present in the hair shaft.
What are the **2 main pigments**?
**Melanin** and **Pheomelanin**
Note:
* **Aging** leads to a decrease in melanin production, resulting in **gray or white hair**.
27
Nails are _____________?
keratinized
28
**Nails** appear ___________ due to the presence of **blood vessels** beneath the nail bed.
pink-tinged
29
WHAT IS THIS?
* Provide protection to the distal surface of the digits and can be used for self-protection.
* In many cultures, length in both men & women is a qualifier of social and economic status.
Nails
30
WHAT IS THIS?
* **Crescent shape at the base of the nail, visible aspect of the nail matrix.**
Lunula
31
MEMORIZE!!!
**"Parts of the Nail"**
OUTER PARTS:
* Edge of nail
* Nail plate
* Lunula
* Cuticle
INNER PARTS:
* Nail bed
* Root of Nail
* Nail matrix
* Hyponychium
* Finger bone
* Epidermis
* Dermis
32
In Collecting the Subjective Data, what are the **4 Informations** we need to get?
* History of Present Concern
* Personal Health History
* Family History
* Lifestyle and Health Practices
33
FAMILIARIZE ONLY!
**"Scope of Present Health Concern in Skin and Hair & Nails"**
**SKIN**
* Skin problems, birthmarks or moles, ABCDEs of skin cancer, ability to feel pain, itching, tingling or numbness, any medications, body odor, excessive perspiration.
**HAIR & NAILS**
* Hair loss or change in the condition, appearance of nails
34
What are the **5 Types of Tattoos**?
* Traumatic Tattoo
* Amateur Tattoo
* Professional Tattoo
* Medical Tattoo
* Cosmetic Tattoo
35
What type of tattoo is this?
* **Caused by debris embedded in the skin.**
* **This occurs when particles (like dirt, ash, or gunpowder) enter the skin due to an accident or injury, leaving a permanent mark.**
Example:
* Motorcycle accident
Traumatic Tattoo
36
What type of tattoo is this?
* Uses **India ink**.
* Created by **non-professionals** using improvised tools. These tattoos often appear uneven, faded, or blurry due to shallow ink penetration.
Amateur Tattoo
37
What type of tattoo is this?
* Made by **trained tattoo artists** using **sterile equipment** and high-quality ink. These tattoos are **precise, detailed, and deeply embedded** in the dermis, making them long-lasting.
**Professional Tattoo**
Note:
* In assessment, put "Presence of a professional tattoo" and then indicate the part of the body (Left or right arm).
38
What type of tattoo is this?
Used in **medical procedures** for various purposes, such as:
* **Marking radiation treatment sites** in cancer therapy.
* **Restoring nipple-areola pigmentation** after breast surgery.
* **Camouflaging scars** or skin conditions like vitiligo.
Medical Tattoo
39
What type of tattoo is this?
Also called **micropigmentation**, this involves tattooing pigments to enhance facial features, such as:
* Eyebrows (Microblading)
* Eyeliner
* Lip tinting
**Cosmetic Tattoo**
Note:
* In assessment, put "Cosmetic Tattoo (eyeliner)"
40
Tattooing is related to what infection?
Hepatitis C infection
41
FAMILIARIZE ONLY!!!
**"How to Examine Own Skin?"**
* **Hair** - Use Mirror, Blower for scalp
* **Nails** - Check hands, elbows, arms, underarms
* **Neck** - Check, women check under breasts for any rashes or discoloration
* **Legs** - Check the legs, soles of the feet, heels, and nails
* **Genitalia** - use mirror
42
FAMILIARIZE ONLY!
**"Specific Health History Questions Regarding the Skin, Hair, and Nails"**
**SKIN HAIR HABITS:**
* Do you use lotion, perfumes, cologne, cosmetics, soap, oils, shaving cream, after shave lotion, electric or standard razor?
* What type of home remedies do you use for skin lesions & rashes?
* How often do you bathe or shower?
* Do you use a tanning bed or salon?
* What type of sun protection do you use?
* Have your ever had a reaction to jewelry that you wore?
* Do you wear hats, visors, gloves, long sleeves or pants, sunscreen when in the sun?
* How much time do you spend in the sun?
**HAIR CARE HABITS:**
* Do you use shampoo, conditioner, hair spray, setting products?
* Do you color, dye, bleach, frost, or use relaxants on your hair?
* What products do you use?
* Do you wear a wig or hairpiece?
* Do you have graying hair or hair loss?
* Do you use hair dryer, heated curlers, or curling iron?
* Do you tightly braid your hair?
**NAIL CARE HABITS:**
* Do you get manicure or pedicures?
* What type of nail care do you practice (trimming, clipping, use of polish, nail tips, acrylics)?
* Do you bite your nails?
* Do you suffer from nail splitting or discoloration?
43
FAMILIARIZE ONLY!
**"General Approach to Skin, Hair, and Nails Assessment"**
1. Ensure that all rooms are well-lit. Daylight is the best source of light, especially when determining skin color. However, if daylight is unavailable, overhead fluorescent lights should be added.
2. Use a handled magnifying glass to aid in inspection when simple visual inspection is not adequate.
3. Explain to the patient each step of the assessment prior to initiating the assessment.
4. Ensure patient privacy by providing drapes.
5. Ensure the comfort of the patient by keeping the room at an appropriate temperature.
6. Warm hands by washing them in warm water prior to the assessment.
7. Gather equipment on a table prior to initiating the assessment.
8. Ask the patient to undress completely & put on a patient gown, leaving the back untied.
9. Perform assessment in a cephalocaudal fashion (head-to-toe).
10. For episodic illness, the skin examination is incorporated into the original physical exam.
44
WHAT IS THIS?
* These are **injuries to the skin and underlying tissues** caused by prolonged pressure, friction, or shear. They often develop in people who are **bedridden**, use wheelchairs, or have limited mobility.
**Pressure ulcers** (bedsores)
Note:
* **Cause** — unrelieved pressure, friction and shear can contribute to and worsen the condition.
* Prevalence vary in bed type & clinical area (critical care, long term facility, prolonged bedrest)
**Stages of Pressure Ulcers:**
* **Stage 1** – Red, non-blanching skin that is intact but painful or warm.
* **Stage 2** – Partial-thickness skin loss, may appear as an open sore or blister.
* **Stage 3** – Full-thickness skin loss, exposing fat layers with a deep wound.
* **Stage 4** – Deep tissue damage, exposing muscles, tendons, or even bone.
45
FAMILIARIZE ONLY!!
**"EQUIPMENTS IN ASSESSING THE SKIN, HAIR, and NAILS"**
* Magnifying glass
* Good source of natural light or examination light
* Penlight with pupil diameter
* Clean gloves
* Microscope slide
* Small centimeter ruler
* Gown
* Braden Scale — Pressure (Risk Assessment)
* Pressure Ulcer Scale for Healing (PUSH)
**For special techniques:**
* Wood's Lamp
* #15 scalpel blade
* Microscope slide w/ cover slips
* Mineral oil
* Microscope
46
WHAT IS THIS?
* It is a widely used **assessment tool** to determine a patient's **risk of developing pressure ulcers (bedsores)**. It evaluates **six risk factors**, assigning a score to each, with a lower total score indicating a higher risk.
Braden Scale
47
WHAT IS THIS?
* It is used to **monitor the healing progress** of pressure ulcers over time. It was developed by the National Pressure Injury Advisory Panel (NPIAP) to help healthcare providers **track improvement or worsening** of ulcers.
**Pressure Ulcer Scale for Healing** (PUSH)
48
WHAT IS THIS?
* It is a **UV (ultraviolet) light** used in dermatology to **detect skin infections, pigment changes, and other skin conditions**. It emits long-wave UVA light (365 nm) and helps identify abnormalities that are not visible under normal light.
Wood's Lamp
49
WHAT IS THIS?
* It is a **chronic skin condition** that causes **loss of pigmentation**, leading to **white patches** on the skin. It occurs when melanocytes (pigment-producing cells) are destroyed, resulting in a lack of melanin.
Vitiligo
50
When doing _________________, you need to observe for the ff:
* Color
* Bleeding
* Ecchymosis (Pasa)
* Vascularity (Ugat-ugat)
* Lesions (scratches)
* Moisture (wet or dry)
* Temperature
* Texture
* Turgor (elasticity)
* Edema (swelling)
Skin Inspection
51
What is the **ideal position** when assessing the patient's skin, hair, and nails?
Supine position
52
FAMILIARIZE ONLY!
**"SKIN INSPECTION"**
**Position**:
* Supine position
**Patient**:
* Wear gown / provide privacy
**Done with gloves**
**Areas to assess**:
* Skin of face, eyelids, nose, lips & mucous membrane
* Neck, behind the ears, arms, chest, breasts, axilla, abdomen, lower extremities, feet, toes, genitalia
**Color**:
NORMAL
* Whitish pink or brown
* Increase pigmentation
* Dark skinned person (discoloration of gums & gingiva)
53
People with **fair or light skin** have **less or decreased melanin,** which provides some protection against UV radiation. This makes them more prone to _______________.
skin cancer
54
___________ skin has **high melanin**.
Darker
55
This is a pigment responsible for the **yellowish tint** in some skin tones.
Carotene
56
__________ tend to have **paler skin** due to **reduced melanin production** and **decreased blood flow (dermal vascularity).**
Older Adults
57
WHAT IS THIS?
* __________ means a noticeable **loss of normal skin color**, making the skin appear pale, ashen, or grayish, especially in individuals with darker skin tones.
* Pallid to ashen without underlying pink.
**Pallor** (Loss of color)
58
WHAT IS THIS?
* It occurs due to **low oxygen levels in the blood**, causing the skin to turn **bluish**.
* It is most noticeable in areas with thin skin, such as the **lips (perioral), nail beds, and conjunctiva.**
**Cyanosis** (Bluish Discoloration)
59
What are the **2 Types of Cyanosis**?
* Central cyanosis
* Peripheral cyanosis
60
What type of cyanosis is this?
* Seen in the **mucous membranes (oral mucosa, lips, tongue)** and suggests a **serious cardiopulmonary problem** (e.g., lung disease, heart failure).
Central Cyanosis
61
What type of cyanosis is this?
* Affects **nail beds, hands, feet, and extremities** due to **poor circulation or vasoconstriction** (e.g., cold exposure, Raynaud’s disease).
**Peripheral Cyanosis**
NOTE:
* **To differentiate**: Always check the **oral mucosa**—if it’s blue, the cyanosis is **central** and could indicate a serious condition.
62
WHAT IS THIS?
* This is skin **redness** caused by **increased blood flow** to the capillaries, usually due to **inflammation, infection, fever, or sunburn.**
**Erythema**
Note:
* It is easier to notice in lighter skin, but in **darker skin tones**, redness may not be visible. Instead, assess **skin temperature** by touching the affected area (it will feel **warmer than surrounding skin**).
63
WHAT IS THIS?
* It refers to the **skin's ability to return to its normal shape after being pinched.**
**Turgor**
NOTE:
It helps assess **hydration status**:
* **Normal**: Skin snaps back quickly.
* **Decreased turgor (tenting)**: Skin stays pinched and returns slowly, indicating **dehydration** or **aging (loss of collagen and elasticity in older adults).**
* Below the clavicular bone.
64
WHAT IS THIS?
* The skin, sclera (whites of the eyes), and mucous membranes turn **yellowish**.
Jaundice
65
WHAT IS THIS?
* **Generalized loss of pigmentation** due to a genetic absence of melanin in the skin, hair, and eyes.
**Albinism**
Note:
* We don't expose these people to sunlight because they are prone to dehydration.
66
WHAT IS THIS?
* ___ is a **chronic autoimmune disease** where the body's immune system attacks its own tissues, causing **widespread inflammation** and damage to various organs, including the skin, joints, kidneys, heart, and lungs.
* A **red, flat or raised rash** that spreads across the **cheeks and nose**, resembling a butterfly shape.
**Systemic Lupus Erythematosus (SLE)**
67
WHAT IS THIS?
* Red central body with **radiating blood vessels** (like a spider’s legs).
Spider Angioma
68
WHAT IS THIS?
* **Bluish or purplish web-like veins** (dilated veins close to the skin).
Venous stars
69
WHAT IS THIS?
* Small, bright **red papules (raised dots).**
Cherry angioma
70
WHAT IS THIS?
This is a **velvety darkening of the skin**, often in **body folds and creases** such as:
* Neck
* Groin
* Axilla (armpits)
It is associated with **insulin resistance, obesity, diabetes, or hormonal disorders.**
Acanthosis Nigricans
71
WHAT IS THIS?
* When assessing skin color variations, also note any ___________.
**odors**
NOTE:
A **strong, foul smell** may indicate a **disorder of the sweat glands**, such as:
* Bacterial overgrowth
* Poor hygiene
* Skin infections
72
FAMILIARIZE ONLY!
**"Skin Lesion Assessment"**
When assessing lesions, observe the symmetry, borders, shape, color, diameter, and changes over time. This helps determine whether a lesion is benign or potentially malignant.
1. **Distribution of Lesions**
* **Diffuse** – Scattered across the body with no specific pattern (e.g., viral rashes).
* **Localized** – Restricted to one specific area or sun-exposed areas (e.g., sunburn, allergic reactions).
2. **Pattern and Arrangement of Lesions**
* **Discrete** – Separate, individual lesions that do not merge (e.g., acne, insect bites).
* **Grouped** – Clusters of lesions appearing together (e.g., herpes simplex, insect bites).
* **Confluent** – Merged or blending together, making it difficult to distinguish individual lesions (e.g., measles, urticaria).
* **Linear** – Lesions arranged in a straight line (e.g., poison ivy rash, scratches).
* **Annular & Arciform** – Circular or arc-shaped lesions (e.g., ringworm for annular, erythema multiforme for arciform).
* **Zosteriform** – Lesions follow a nerve pathway in a band-like pattern, common in herpes zoster (shingles).
3. **Assessing Small Lesions**
* Use a **magnifying glass** to better examine small lesions for **texture, shape, and color changes.**
* Pay attention to **location, distribution, and configuration** to help determine the underlying cause.
4. **Fungal Infections & Wood’s Light Exam**
* **Wood’s light** (UV light filtered through a special glass) is used to detect certain fungal infections.
* Findings under Wood’s Light:
= > **No fluorescence** → Lesion is **not fungal.**
= > **Blue-green fluorescence** → Suggests a **fungal infection**, like tinea (ringworm).
73
FAMILIARIZE ONLY!
**"Classification of lesions based on their location, arrangement, elevation, color, and exudates"**
**Lesion Classification:**
1. **Non-Palpable Lesions**
* These are **flat** and cannot be felt when touching the skin.
* Example: Macule (e.g., freckles, flat moles).
2. **Palpable Lesions**
* These can be **felt and raised** above the skin surface.
Examples:
* **Papule** – A small, solid, raised lesion (e.g., warts, moles).
* **Nodule** – A deeper, firmer mass extending into the dermis (e.g., lipoma).
* **Wheal** – A raised, irregular-shaped area due to fluid accumulation (e.g., hives).
3. **Fluid-Filled Lesions**
* These contain **liquid** inside.
Examples:
* **Vesicle** – A small, fluid-filled blister (e.g., chickenpox, herpes).
* **Pustule** – A pus-filled lesion (e.g., acne, impetigo).
4. **Lesions Above the Skin Surface**
* These are **elevated** due to excess skin formation.
Examples:
* **Scales** – Flakes of dead skin (e.g., psoriasis, dandruff).
* **Crusts** – Dried exudates (e.g., scab from a healing wound).
5. **Lesions Below the Skin Surface**
* These involve **loss of skin tissue or deep structural changes.**
Examples:
* **Erosion** – Superficial loss of epidermis (e.g., after a blister pops).
* **Ulcer** – Deep loss of skin tissue with possible scarring (e.g., pressure ulcers).
* **Keloid** – Overgrowth of scar tissue beyond the original wound.
* **Fissure** – A deep crack or split in the skin (e.g., cracked heels, angular cheilitis).
* **Scar** – Fibrous tissue replacing normal skin after healing.
* **Excoriation** – Superficial skin loss due to scratching (e.g., insect bite marks).
74
WHAT IS THIS?
* It is a **type of cancer that begins in epithelial cells**, which line the skin and internal organs. It is one of the most common forms of cancer and can occur in different parts of the body, including the skin, lungs, breasts, prostate, and digestive tract.
Carcinoma
75
Carcinoma can be ___________ or ____________.
Primary or Secondary
76
This is the Carcinoma that **originates in the skin itself**.
Primary Carcinoma
77
This is the Carcinoma that **spreads (metastasizes) from another part of the body to the skin.**
Secondary carcinoma
78
What are the **3 Classification of Skin Cancer**?
* Squamous Cell Carcinoma (SCC)
* Basal Cell Carcinoma (BCC)
* Malignant Melanoma
79
Under the classification of Skin Cancer, what is this?
* Develops from squamous cells in the epidermis.
* Often appears as a **scaly, red patch, open sore, or thickened skin.**
* Can metastasize if untreated.
* Commonly caused by prolonged **sun exposure.**
Squamous Cell Carcinoma (SCC)
80
Under the classification of Skin Cancer, what is this?
* Most common but **least aggressive** type.
* Appears as a **pearly or waxy bump, sore that doesn’t heal, or reddish patch.**
* Grows slowly and rarely spreads.
* Linked to **UV radiation exposure.**
Basal Cell Carcinoma (BCC)
81
Under the classification of Skin Cancer, what is this?
* **Most dangerous** form of skin cancer.
* Arises from **melanocytes** (pigment-producing cells).
* Can spread quickly to other organs.
* Often starts as a **new mole or changes in an existing mole.**
Malignant Melanoma
82
What is the **ABCDEs** of Skin Cancer (Warning Signs of Melanoma)?
* **A – Asymmetry:** One half of the mole is different from the other.
* **B – Border:** Irregular, scalloped, or poorly defined edges.
* **C – Color:** Varied shades of brown, black, red, blue, or white.
* **D – Diameter:** Larger than 6mm (about the size of a pencil eraser).
* **E – Evolving:** Any change in size, shape, color, or symptoms (bleeding, itching, etc.).
NOTE:
* If caught & treated early, before it advances & spreads to other parts of your body, melanoma can almost always be cured.
83
In Skin Assessment, the Texture is assess by using the Palmar surface of __________________?
**Three middle fingers**
84
SKIN ASSESSMENT
* **Rough, flaky texture** skin can indicate what?
hypothyroidism
85
SKIN ASSESSMENT
* **Dirty and itchy skin** is often observed in ________ individuals due to poor hygiene or friction.
Obese
86
SKIN ASSESSMENT
* The ___________ and __________ of the skin is common to **patient with constant pressure** and **taking steroids.**
thickness and thinness
87
SKIN ASSESSMENT
* **Cold, clammy skin** indicates possible _______________?
shock or hypotension
88
SKIN ASSESSMENT
* **Cool skin** may indicate ___________ (poor circulation).
arterial disease
89
SKIN ASSESSMENT
* ______________: Assesses **hydration and skin elasticity**
* Method: As the patient to **lie down**, pinch the skin over the **clavicle** using two fingers.
* **Normal**: Skin is **mobile, elastic, and quickly returns to its original shape**.
**Turgor**
Note:
* **Recoil is immediate**.
90
SKIN ASSESSMENT - Turgor
* If the Recoil time is **less than 2 secs**, it means ______________.
Moderate Dehydration (DHN)
91
SKIN ASSESSMENT - Turgor
* If the Recoil time is **more than 2 secs**, it means ______________.
Severe Dehydration (DHN)
92
SKIN ASSESSMENT - Turgor
* If the Recoil time is **more than 3 secs**, it means ______________.
Tenting
93
FAMILIARIZE ONLY!
**"PALPATION OF THE SKIN"**
1. **Moisture** - Dry w/ perspiration
2. **Temperature** - Warm & equal bilateral
3. **Tenderness** - Surface is non tender
4. **Texture** - Smooth, even, firm
5. **Turgor** - Should return to its original contour rapidly
6. **Thickness** - Thin but calluses (constant pressure.
7. **Edema**
94
4 Point Scale (Edema)
* +0 - No pitting
* +1 - 0'' - 1/4'' MILD
* +2 - 1/4'' - 1/2'' MODERATE
* +3 - 1/2'' - 1'' SIGNIFICANT
* +4 - greater than 1'' PITTING
95
In **skin assessment**, a ___________ refers to an area of the body where **bones are close to the skin's surface**, making it more prone to **pressure ulcers (bedsores)** due to prolonged pressure, friction, or shear forces.
Pressure points
96
In **Supine Position**, what are the (4) pressure points?
* Occiput
* Scalpula
* Sacrum
* Heels
97
In **Lateral Position**, What are the (7) Pressure Points?
1. Ear
2. Acromion process
3. Elbow
4. Trochanter
5. Medial and lateral condyle
6. Medial and lateral malleolus
7. Heels
98
In **Prone Position**, what are the (7) Pressure Points?
1. Elbow
2. Ear, cheek, nose
3. Breasts (female)
4. Genitalia (male)
5. Iliac crest
6. Patella
7. Toes
99
What is the **scale** used to predict **pressure sore risk**?
Braden Scale
100
What is the **tool** used to **document the degree of skin breakdown**?
**PUSH tool** or Pressure Ulcer Scale for Healing
101
What should a nurse do to **prevent bedsores**?
Turning should be done every **2 hours**
102
IN NAIL ASSESSMENT, what is this?
* Indicate **poor hygiene**; may reflect the **client's work or hobbies** (e.g., mechanics, gardeners).
Dirty nails
103
IN NAIL ASSESSMENT, what is this?
* Suggest **hypoxia** (lack of oxygen) or **anemia**.
**Pale** or **cyanotic nails**
104
IN NAIL ASSESSMENT, what is this?
* Tiny red or brown streaks under the nail; may be due to **trauma** or **endocarditis.**
Splinter hemorrhage
105
IN NAIL ASSESSMENT, what is this?
* Horizontal depressions across the nail; occur **after acute illness**, malnutrition, or chemotherapy.
Beau’s lines
106
IN NAIL ASSESSMENT, what is this?
* Associated with **fungal infection (onychomycosis)** or **psoriasis.**
Yellow discoloration
107
IN NAIL ASSESSMENT, what is this?
* May indicate **poor circulation** or **fungal infection (onychomycosis).**
Thickened nails
108
What is the **normal color of our nails**?
Pink & brown
109
In testing the capillary refill, what is the **normal time**"?
1-2 secs or **less than 2 secs**"
110
In capillary refill time, how many secs is considered **abnormal**?
**2-3 secs and above**
Note:
* When the capillary refill time is abnormal, then it indicates CVD (Cardiovascular Disease)
111
IN NAIL ASSESSMENT, under shape & configuration.
* The nails should be **smooth & rounded or flat**
* What should be normal **angle**?
160°
112
IN NAIL ABNORMALITIES, what is this?
* Angle between the nail and nail bed is **180° or more** with a **spongy sensation** when pressed.
**Clubbing of Nails**
Note:
* People who has this actually experienced **prolonged difficulty of breathing**. So they often have upper or lower respiratory diseases. This is common to **smokers**
113
IN NAIL ABNORMALITIES, what is this?
* Thin, concave (spoon-shaped) nails that may hold a drop of water.
Cause: **Iron deficiency anemia.**
Spoon nails
114
IN NAIL ABNORMALITIES, what is this?
* A **fungal infection of the nails**, commonly affecting toenails more than fingernails.
Onychomycosis
115
IN NAIL ABNORMALITIES, what is this?
* **Inflammation of the skin around the nail** (nail folds).
Paronychia
116
IN NAIL ABNORMALITIES, what is this?
* **Separation or detachment of the nail from the nail bed.**
Onycholysis
117
IN INSPECTION OF ______:
We inspect the ff:
* Scalp hair
* Eyebrows
* Eyelashes
* Body hair
Hair
118
At how many inch intervals do we inspect the **scalp cleanliness, parasites, and lesions**?
1 inch intervals
119
IN INSPECTION OF HAIR, what is this?
**Excessive scaliness** may indicate ________?
Dermatitis
120
IN INSPECTION OF HAIR, what is this?
* **Lesions** could suggest a _______ or ________.
Tumor or infection
121
IN INSPECTION OF HAIR, what is this?
* **Dull or dry hair** is common in _________ and ___________.
**Hypothyroidism** and **Malnutrition**
122
IN HAIR CONDITIONS, what is this?
* This is also called as **scalp ringworm**.
* **Fungal infection** causing **round, scaly patches and hair breakage.**
Tinea capitis
123
IN HAIR ABNORMALITIES
The ff indicates what?
* Infections
* Nutritional deficiencies
* Hormonal imbalances (thyroid disorders)
* Liver disease, drug toxicity, hepatic or renal failure
Excessive Generalized Hair Loss
124
IN HAIR ABNORMALITIES
The _______ can be seen in:
* Chemotherapy
* Infections (e.g., tinea capitis, alopecia areata)
Patch hair loss
125
IN HAIR CONDITIONS, what is this?
* This refers to **hair loss** or **absence of hair** in areas where it is normally present. It can be temporary or permanent, depending on the cause.
Alopecia
126
IN HAIR CONDITIONS, what is this?
* An **autoimmune condition**, body's immune system attacks the health cells including the hair follicle causing **patch hair loss** on the scalp or body.
Alopecia Areata
127
IN HAIR ABNORMALITIES, what is this?
* It is the **excessive growth of coarse, dark hair** in areas where women typically have minimal hair (face, chest, back).
**Hirsutism**
Note:
* Characterized of Cushing Disease and Polycystic ovary syndrome (PCOS) and results in imbalance of adrenal hormones or side effect of steroids.
**Cushing disease is the overproduction of ACTH**
128
WHAT IS THIS?
* **Ovaries produce excess androgens (male hormones).**
* **Leads to irregular periods, acne, and fluid-filled sacs (cysts) in the ovaries.**
**Polycystic Ovary Syndrome** (PCOS)
129
WHAT IS THIS?
* A **male sex hormone** present in both men and women, but in small amounts in females.
Androgens
130
WHAT IS THIS?
* **Multiple cysts (fluid-filled sac) in the ovaries.**
**Polycystic**
Note:
* **"Poly"** (many) + **"Cystic"** (fluid-filled sacs)
131
WHAT IS THIS?
* It is the **inflammation or infection of hair follicles**, leading to small red bumps, pustules, or irritation on the skin.
Folliculitis
132
FAMILIARIZE ONLY!
**"SKIN, HAIR, AND NAILS"**
**Inspection of the Skin**
* Color
* Bleeding, ecchymosis, and vascularity
* Lesions
**Palpation of the Skin**
* Moisture
* Temperature
* Tenderness
* Texture
* Turgor
* Edema
**Inspection of the Hair**
* Color
* Distribution
* Lesions
**Palpation of the Hair**
* Texture
**Inspection of the Nails**
* Color
* Shape & Configuration
**Palpation of the Nails**
* Texture
133
WHAT IS THIS?
* **Infestation** of hairy parts of the body or clothing with **eggs, larvae, or adult lice**. Feed with human blood that causes itching sensation.
**Pediculosis**
134
What are the **3 Types of Pediculosis**?
* Head lice
* Crab lice
* Body lice
135
What is the treatment for pediculosis?
**Permethrin** lotion or shampoo
136
IN SKIN ABNORMALITIES
* *A 63 year old woman presents with symmetrical, yellowish plaques over both eyelids, painless and slowly enlarging over time.*
* Caused by **high level of LDL (Low Density Lipoprotein) cholesterol**
Xanthelasma
