integumentary assessment

what are the two main layers of the skin

epidermis and dermis

the outer layer of skin

epidermis

the inner supportive layer

dermis

what are the main parts of the nail

nail plate, nail bed, nail matrix, cuticle, lunula, nail folds

what are the main functions of the skin

protection, perception, temperature regulation, identification, communication, wound repair, absorption/excretion, vitamin D production

find, downy hair on a newborn

lanugo

thick, cheesy substance on newborn skin

vernix caseosa

what can sebum contribute to in newborns

milia

what skin change occurs in children

epidermis becomes thicker, darker, and more lubricated

what changes occur in adolescents

increased apocrine secretions, increased subcutaneous fat, secondary sex characteristics

increased pigmentation along the midline of the abdomen during pregnancy

linea nigra

facial discoloration called the mask of pregnancy

chloasma

stretch marks on the abdomen, breasts, and thighs during pregnancy

striae gravidarum

what happens to skin elasticity with aging

it decreases, causing skin to sag and fold

why does older adult skin become dry

decreased sweat and sebaceous gland function

discoloration caused by fragile capillaries

senile purpura

what happens to wound healing with aging

it becomes slower

why does hair become gray with aging

decreased functioning melanocytes

what is xerosis

dry skin

what should you ask about during a subjective skin assessment

rash, itching, sores, pigment changes, dryness/moisture, bruising, hair loss, nail changes, exposures

why should you ask about new antibiotics in a skin assessment

they may cause rash or itching

why ask about anticoagulants or antiplatelets in a skin assessment

they may cause easy bruising or bleeding

what equipment may be used for a skin assessment

strong lighting, gloves, penlight, centimeter ruler

what special equipment may be used for a skin assessment

Wood’s light and magnifying glass

what should you inspect for on the skin

pigmentation, moisture, thickness, edema, bruising, lesions

what skin finding may occur with liver failure

Jaundice

what do you palpate on the skin

moisture, temperature, texture, edema, turgor, bruising, lesions

what part of the hand is used to assess skin temperature

back of the hand

what does skin turgor assess

how quickly skin returns after being lifted or pinched

what do you assess on the nails

shape, contour, consistency, color, capillary refill

how do you assess capillary refill

blanch the nail, release, and watch color return

what is normal capillary refill

color returns immediately

what is sluggish capillary refill

color return takes more than 3 seconds

what does capillary refill assess

peripheral circulation

mongolian spot

cafe-au-lait spot

harlequin change

erythema toxicum

acrocyanosis

physiologic jaundice

stork bite

what does A in ABCDE stand for

asymmetry

what does B stand for in ABCDE

border irregularity

what does C stand for in ABCDE

color variation

what does D stand for in ABCDE

diameter > 6mm

what does E in ABCDE stand for

elevation or evolution

circular or ring-shaped

annular

lesions run together

confluent

separate individual lesions

discrete

lesions are clustered together

grouped

a group of reactive red rashes that form distinctive ring-like, wavy, or wood-grain patterns on the body

gyrate

a distinct ring-like skin mark that often resembles a bullseye

target/iris

lesions form a line

linear

rashes that form complex, multi-ringed patterns when individual circular or ring-shaped lesions grow and merge together

polycyclic

rash or lesion pattern that is distributed in a single, unilateral band along a specific nerve pathway, or dermatome

zosteriform

flat area of color change

macule

what is an example of a macule

freckle

small, raised lesion

papule

larger flat area of color change

patch

raised area; may appear scaly

plaque

small, clear-fluid-filled lesion

vesicle

larger fluid-filled blister

bulla

raised lesion filled with pus

pustule

a small, rounded, abnormal growth or lump of tissue that can form just under the skin, in internal organs, or within glands

nodule

itchy, raised bumps or welts on the skin that happen when your body releases histamine

urticaria/hives

a closed, sac-like pocket of tissue anywhere in the body that can be filled with fluid, pus, air, or other materials

cyst

loss or opening of skin tissue

ulcer

superficial skin loss, often from scratching

excoriation

thickened skin

lichenification

excessive scar tissue extending beyond the original wound

keloid

common, benign tumors made up of an extra cluster of blood vessels that can appear on the skin or inside internal organs

hemangiomas

permanent widening of tiny blood vessels near the surface of the skin or mucous membranes

telangiectasis

small pinpoint areas of bleeding

petechiae

larger areas of bleeding than petechiae

purpura

what is a contusion

bruise

collection of blood within tissue

hematoma

an inflammatory skin reaction in the diaper area caused mainly by prolonged exposure to moisture, urine, and stool

diaper dermatitis

a fungal infection caused by an overgrowth of Candida, a type of yeast that normally lives on the skin and inside the body common in children

candidiasis

bacterial skin infection characterized by red sores or fluid-filled blisters that rupture and form characteristic honey-colored crusts common in children

impetigo

long term skin disease that causes dry, red, and very itchy skin

eczema

what is atopic dermatitis

eczema

a highly contagious viral illness that causes a high fever, cough, runny nose, red eyes, and a spreading red rash common in children

measles/rubeola

contagious viral infection best known for causing a mild pink or red rash common in children

german measles/rubella

what is chickenpox also called

varicella

circular/ring-shaped fungal lesion

tinea corporis

what is herpes zoster

singles

classic bull’s-eye rash associated with Lyme disease

erythema migrans

inflammation/infection around hair follicles

folliculitis

skin infection causing redness, warmth, swelling, and inflammation

cellulitis

contagious fungal infection of the scalp and hair follicles that most commonly affects children

tinea capitis

abnormal changes that develop on previously heatlhy skin

primary skin lesions

form from the evolution, injury, or manipulation of a primary lesion

secondary skin lesions