Skin/Hair/Nails Assessment Fundamentals Exam 2

How often do you bathe? Is it subjective/objective data?

subjective

Family history of skin diseases? subjective or objective

subjective

personal history of skin diseases? subjective/objective

subjective

do you have any pain? subjective/objective

subjective

do you have any allergies? subjective/objective

subjective

looking for even color or lesions in the skin. Is this subjective or objective

objective

Assessing the skin for even temperature is subjective or objective data

objective

assessing the skin for presence/absence of moisture is subjective or objective data?

objective

assessing the elasticity/turgor of the skin is an example of subjective or objective data

objective

assessing the angle of the nail beds is an example of subjective or objective data?

objective

what is the normal nail bed angle

160 degrees

what nail bed angle is associated with clubbing

180 degrees

what primary skin lesion has a <1cm diameter with a circumscribed border, and is flat, non-palpable, and changes in color?

macule

what primary skin lesion has a >1cm diameter, may have an irregular border, is flat, non-palpable, and changes in color

patch

what’s an example of a macule

freckles

what’s an example of a patch

port wine stain or bruising

what primary skin lesion has a diameter of <.5cm, and is a palpable, elevated mass with a circumscribed border?

papule

what’s an example of a papule

wart

what primary skin lesion has a >.5cm diameter, is deep and firm, and is a palpable, elevated solid mass with a circumscribed border

plaque

what’s an example of a plaque

psoriasis

What’s an example of a primary skin lesion that has a 0.5-2cm diameter with a circumscribed border? It’s also an elevated, solid, palpable mass that extends deeper into the dermis than a papule.

nodule

what’s an example of a nodule

lipoma

what is a primary skin lesion that has a diameter of 1-2 cm with a sharp border (but not always present). It’s also an elevated, solid, palpable mass that extends deeper into the dermis than a papule.

tumor

what’s an example of a tumor

carcinoma

what’s an example of a primary skin lesion that has a diameter of <.5cm that has circumscribed borders and superficial elevations of the skin by fluid?

vesicle

what’s an example of a vesicle

Herpes simplex, chickenpox

what is a primary skin lesion with a diameter of >.5cm, with circumscribed borders, and a superficial elevation of the skin by fluid?

bulla

what’s an example of a bulla

contact dermatitis

what is a primary skin lesion that is a pus-filled vesicle or bulla? 

pustule

what’s an example of a pustule

acne

what is a primary skin lesion that is an elevated mass with transient borders? It is often irregular in size, and the color varies. It results from a movement of serous fluid into the dermis.

wheal

what’s an example of a wheal?

hives, insect bites

what is a primary skin lesion that is an encapsulated fluid-filled or semisolid mass located into the subcutaneous tissue or dermis?

cyst

what is melanoma

a type of skin cancer

What do the ABCDEs of melanoma stand for

Asymmetry, border, color, diameter, enlarged/elevated

what is an intervention to prevent pressure ulcers

Rotate the patient every 2 hours

what is friction

two surfaces rubbing together

what is shearing

when the skin goes one way, and the muscle/bone goes the opposite way

why can shearing/friction and sitting for too long cause pressure ulcers

no blood flow

what is the purpose of the braden scale?

to assess a patient’s risk for pressure ulcers/skin breakdown

what are the categories in the Braden scale?

sensory perception, moisture, activity, mobility, nutrition, friction/shear

how do you position an unconscious patient when doing oral care? why?

On their side, to prevent choking