2 integumentary system

THE SKIN

Maria Carmela L. Domocmat, RN, MSN

STEP 1


STEP 2

Confirm that the

skin is clean

and free from and free from

body odor.


STEP 3

Cyanosis Carotenemia

Jaundice


Inspecting the palms is anopportunity toassess overallassess overallcoloration.


STEP 4

Inspect the skin for even

pigmentation over the body.pigmentation over the body.


Freckles Versicolor

Vitiligo

Nevus

Vitiligo


STEP 5

Determine

the Client’s

skin skin

temperature


STEP 6

Assess the amount

of moisture

on the skin on the skin

surface and

texture.


STEP 7

Palpate to assess thickness

STEP 8 STEP 8

Palpating to assess skin elasticity

and mobility.


Testing for skin tenting

Assessing skin turgor

Tenting


Edema of the

hand

STEP 9

Palpate

to

detectdetect

edemaPitting Edema


STEP 10

Inspect the

skin for

superficial

Spider Angioma

Venoussuperficial

arteries and

veinsSpider Vein

VenousStar


STEP 11

Inspect and palpate the skin for

lesion.Referral

If you notice drainagefrom any lesion, put

on gloves beforeproceeding with the

assessment.

Referral

Suspect physical abuse. Be especially

sensitive if client is fearful and has a history

of previous injuries. Obtain medical assistance

and follow your states’ legal requirements to

notify the police or local protective agency.


STEP 12

Palpate the skin for sensitivity


Evaluating Skin Lesions

A – (assymetrical)

B – (borders)

C – (color)C – (color)

D – ( diameter)

E – (elevation)


PRIMARY LESIONS

MACULE, PATCH

NevusFreckles

Nevus

Petechiae

Vitiligo


Ecchymosis Mongolianspot

Chloasma

Rubella Purpura


Papule, Plaque

Lichen Planus

WartsEczema


Psoriasis


PatchNodule

Tumor

(café-au-lait spot)

Nodule, tumor

PatchNodule

A combination typical of neurofibromatosisMaria Carmela L. Domocmat, RN, MSN

Vesicle, Bulla

Atopic Dermatitis

Vesicle


Erythema multiforme

Bulla

Chicken Pox

PemphigusMaria Carmela L. Domocmat, RN, MSN

Wheal

Wheal in a drugeruption in an eruption in an infant

Urticaria


Pustule

Pustular psoriasis

Furuncle

Impetigo

Furuncle


Acne


Cyst


Secondary Skin Lesions

LichenificationMaria Carmela L. Domocmat, RN, MSN

Atrophy

Aged Skin

Striae


Ulcer

Ulcer fromUlcer from

Venous

Stasis


Erosion

Apthous Ulcer


Fissure

Fissured Tongue Athlete’s Foot


Crust

Ruptured vesiclesvesiclesof herpes simplex


Keloid

Keloid ofKeloid ofear piercing


Cancerous Skin Lesions

Nodule

Ulcer

Tumor

Telengiectasia


Cancerous Skin Lesions

Nodule

Uler Tumor

Telengiectasia


Kaposi’sSarcoma


Malignant

MelanomaSuperficial Spreading

Nodular

Serious Type ofSkin Cancer


Common Skin Variationsin Older Clients

Cutaneous Tags


Cutaneous Horn

Cherry Angiomas

Senile Lentigines

Cutaneous Horn


Hair AssessmentHair Assessment


Inspect the

scalp and

hair

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.


STEP 2

�Varies according to the level of melanin production

STEP 3

�Roll a few strands of hair between your thumb and forefinger.

Observe the client’s hair color

Assess the textureof the hair

production�Graying is influenced by genetics�Graying in patches may indicate a nutritional deficiency.

forefinger.�Hold a few strands of hair

taut with one hand while youslide the thumb and forefingerof your other hand along thelength of the strand.


STEP 4

> Observe the amount and distribution of the hair

Male Pattern Balding

the hair throughout thescalp – varies with age, sex, and overall health.


STEP 5

Inspect thescalp for lesions.

Regions of infection will fluoresce when exposed

to the ultraviolet lightof a Wood’s lamp.lesions.

�Dim the room light and shine a Wood’s lamp on theclient’s scalp as you part the hair.


Palpation of Hair

1. Palpate the hair between your fingertips.fingertips.

2. Note the condition of the hair form the scalp to the end the hair.


Abnormalities of

Hair and Scalp

PediculosisPediculosisCapitis (head lice)


Hirsutism -excess body hair in females, following the male pattern. Typically due to endocrine or metabolic dysfunction, or idiopathic.

Side-effect ofCyclosporin


Alopecia Areata


Constant feature of Kwashiorkorbut may also be seen in Marasmus.

Dry hair; lacks normal lustre


The ‘flag-sign’ or signa de bandera

-alternating darker and lighter bands when held up.

Trichotillomania


Tinea Capitis

Seborrheic Dermatitis


Symptoms of Scurvy-hairs on most parts of the body become corksrew-shaped

Lanugo hair


Menke’s kinky hair syndrome

Sparse and brittle hairin this sex-linked disordercaused by a defect in caused by a defect in intestinal copper absorption


Assessing

thethe

Nails


Inspect nail grooming and cleanliness

STEP 1

STEP 2

Inspect nail color and markings.


STEP 3

Assess capillary refill


STEP 4

Inspect and

palpate the

nails for nails for

shape and

contour.Schamroth Technique


Curvature of the normal nail

Clubbing of the nail

Spoon nail


STEP 5

Palpate the nails to determine

thickness, regularity, and

attachment to the nail bed.

STEP 6

Inspect and palpate the cuticles.


Common Nail Disorders

Clubbing of the finger

In clubbing, the distal phalanx of each finger is roundedand 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.


Paronychia


ONYCHOLYSIS

With Hyperkeratosis


Beau’s Lines

�Are transverse depressions in the nails associated with acute severe illness. The lines emerge from underthe proximal nail folds weeks later and grow graduallyout with the nails.


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


Transverse White Lines Transverse White Lines (Mees’’Lines) �Curves are similar to those of the

lunula, not the cuticle, and may followan acute or severe illness.


Onycho-cryptosis

Psoriasis Subungal Hematoma

LongitudinalMelanonychia

Eggshell Nail Onychomycosis


Onychauxis OnychatrophiaLeukonychia

Onychophagy Onychorrhexis Pteryigium


Palpation of the Hair�TextureInspection of the Nails�Color�Shape and ConfigurationPalpation of the Nails�Texture�Texture


2 integumentary system

Health & Medicine

Transcript of 2 integumentary system