Hair, Skin, Nails Health Assessment

What are the primary protective functions of the skin?

Protects underlying tissues from microorganisms, physical trauma, UV radiation, and dehydration.

What vital roles does the skin play in the body?

Temperature maintenance, fluid and electrolyte balance, absorption and excretion, sensation, immunity, and vitamin D synthesis.

Why is skin thicker on the palms of hands and soles of feet?

Because they are exposed to more friction daily, acting as a protective barrier.

What does skin assessment involve?

Palpation and inspection of color, moisture, temperature, thickness, texture, mobility, turgor, and lesions.

What does pallor indicate?

It can indicate anemia, shock, or arterial insufficiency and is common in high-stress states.

Where is pallor best observed?

In mucous membranes, lips, and nail beds; palpable conjunctiva and nail beds are preferred sites for assessing pallor from anemia.

What is erythema?

Intense redness from excess blood (hyperemia) due to dilated superficial capillaries, expected with fever or localized infection.

What does cyanosis indicate?

A bluish mottled color indicating decreased blood perfusion of tissue from oxygenated blood.

Where is cyanosis best seen?

In high vascular parts of the body with thin epidermis, such as lips, nose, cheeks, ears, and oral mucous membranes.

What is jaundice a sign of?

It indicates rising bilirubin in the blood, first noticed in the junction of hard and soft palate or sclera.

What is vitiligo?

An acquired condition with complete absence of melanin in certain parts of the body, leading to white or pale skin.

What characterizes acanthosis nigricans?

Areas of dark, velvety discoloration in body folds and creases, often associated with obesity or diabetes.

What is diaphoresis?

Profuse sweating expected with increased activity or fever.

What happens to skin as people age?

The number of sweat and sebaceous glands decreases, leading to dry skin (xerosis) and increased susceptibility to heat.

What is edema?

Fluid accumulation in interstitial spaces, usually in lower extremities, graded on a scale of +1 to +4.

What are the causes of edema?

Deep venous thrombosis (DVT), chronic venous insufficiency, lymphedema, orthostatic edema, and congestive heart failure.

How is skin mobility and turgor assessed?

By pinching the skin on the anterior chest or dorsum of the hand; normal skin should easily lift and return to normal.

What are primary skin lesions?

Lesions that develop on previously unaltered skin as an immediate result of a specific causative factor.

What is a macule?

A flat, well-circumscribed lesion up to 1 cm in diameter.

What is a papule?

A raised bump up to 1 cm in diameter.

What is a cyst?

An elevated, circumcised area filled with liquid or semisolid fluid.

What is a wheal?

An elevated, irregularly shaped area of cutaneous edema that is solid and transient.

What is a vesicle?

A clear, fluid-filled blister up to 1 cm.

What is a bulla?

A vesicle greater than 1 cm.

What is a pustule?

An elevated, pus-filled lesion up to 1 cm.

What is a scale in terms of skin lesions?

Heaped-up keratinized cells; flaky exfoliation of variable size.

What is a fissure?

A split in all epidermal layers.

What does the ABCDE method stand for in skin cancer education?

Asymmetry, Borders, Color, Diameter, and Evolving.

What is the primary recommendation for reducing sun exposure?

Wear sunscreen and protective clothing like long-sleeved shirts and wide-brimmed hats.

What are pressure injuries?

Localized damage to the skin and underlying soft tissue, usually occurring over bony prominences.

What are common sites for pressure injuries?

Heels, inner knees, lower back, buttocks, elbows, shoulders, back of the head, and hips.

What is the Braden Scale used for?

Assessing skin integrity and risk for pressure injuries.

What scoring indicates a mild risk on the Braden Scale?

A score of 15-16.

What is alopecia?

Hair loss.

What is traction alopecia?

Hair loss caused by constant pulling of the hair from the scalp.

What is the most common cause of hirsutism?

Polycystic ovary syndrome (PCOS).

What hormonal changes occur during pregnancy affecting hair?

Increased levels of estrogen, progesterone, and prolactin lead to increased hair growth and thickness.

What is the normal profile sign angle for nails?

160 degrees.

What does clubbing of the nails indicate?

Chronic low oxygen levels, often due to conditions like COPD or cardiac diseases.

What are normal findings when inspecting nails?

Nails should be slightly curved or flat, smooth, and clean.

What changes occur in nails as people age?

Nail growth rate decreases, nails may become brittle, and thickening can occur.

What is the significance of capillary refill time?

Normal capillary refill time is less than 2 seconds, indicating good circulation.

What subjective data should be collected during a skin, hair, and nails assessment?

History of present health concerns, personal health history, family history, and lifestyle factors.

What are objective data in a skin, hair, and nails assessment?

Observations that reveal local or systemic issues affecting skin, hair, or nails.

What can systemic issues affecting skin, hair, and nails include?

Impaired circulation, endocrine imbalances, allergic reactions, or respiratory disorders.

What is the impact of aging on skin appearance?

Skin may become pale, dry, saggy, or wrinkled with decreased turgor.

What is the result of decreased oil production in hair?

Lack of luster and softness in hair.

What is the relationship between estrogen and hair in aging females?

Decreased estrogen can lead to slow scalp hair loss and increased facial hair growth.

What is leukonychia?

A linear white band marking on nails that can result from trauma.

What is the effect of gender-affirming hormone therapy on hair?

Testosterone can increase hair growth and thickness, while estrogen may thin hair.

What are secondary skin lesions?

lesions that came from a primary injury, scratching, or secondary infection

what is a scale?

keratinized cells with flakey exfoliation (can be thick or thin; dry or oily; variable size; can be white or tan)

what is a crust?

variable size wound that is slightly elevated (collection of dried serum, blood, or purulent exudate)

what is a fissure?

split through all epidermal layers of skin

what is an ulcer?

loss of skin through the epidermis with damage to the dermis

what is a scar?

permanent fibrnotic skin change

what is atrophy?

localized shrinking of the skin?

what is Lichenification?

rough, thickened epidermis that can be accentuated by skin markings (from rubbing or scratching)