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Assessing Skin, Hair & Nails

Assessing Skin, Hair & Nails. NUR123 Spring 2009 K. Burger, MSEd, MSN, RN, CNE PPP by: Victoria Siegel RN, CNS, MS Sharon Niggemeier RN, MSN Revised by: Kathleen Burger. Assessing the Skin. Integumentary System= skin, hair, nails.

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Assessing Skin, Hair & Nails

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  1. Assessing Skin, Hair & Nails NUR123 Spring 2009 K. Burger, MSEd, MSN, RN, CNE PPP by: Victoria Siegel RN, CNS, MS Sharon Niggemeier RN, MSN Revised by: Kathleen Burger

  2. Assessing the Skin • Integumentary System= skin, hair, nails. • Skin- Epidermis, Dermis, Subcutaneous tissue • Incorporates subjective and objective assessments • Includes inspection and palpation techniques

  3. Subjective Assessment: Skin • Past history of skin disorders? • Changes in skin color? • Changes in a mole? • Excessive dryness, or moisture? • Pruritis?

  4. Subjective Assessment: Skin • Excessive bruising? • Rash or lesion? • Meds • Environmental hazards- work, sun, insects, plants • Self care- cosmetics, soaps, etc.

  5. Objective Assessment- Skin • Equipment:Strong, direct lighting, small centimeter ruler, penlight, gloves • Assess hands, nails FIRST= nonthreatening

  6. Objective Assessment- Skin • Color • Pigmentations: Freckles, Nevus (mole), Birthmarks • Temperature • Texture • Moisture • Edema • Turgor • Bruising

  7. Assessment of Lesions • Color • Shape • Size in cm • Elevation (flat or raised) • Location and distribution on body • Exudate (color, odor)

  8. Assessing Hair • Inspection and palpation • Color • Texture • Distribution • Lesions of scalp

  9. Assessment of Nails • Shape and contour: slightly curved or flat and smooth, 160 degrees. • Consistency- surface smooth and regular, not brittle or splitting, uniform thickness. • Capillary Refill- depress nailbed color blanches , color should return <1-2 seconds

  10. Health Promotion • Teach all adults to examine skin once a month & to have a yearly exam by dermatologist. • Teach diabetics the importance of skin care to feet

  11. Health Promotion • Danger signs of pigmented lesions (moles): • A - Asymmetrical Shape • B - Border Irregularity • C - Color • D - Diameter greater than 6mm • E - Elevation (flat or raised).

  12. Summary • General survey – overall appearance of an individual…beginning of the physical health assessment • Physical health assessment begins with the skin including the hair and nails • Includes inspection & palpation • Health promotion through teaching is incorporated

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