NURM-102 Skin Assessment Review

Debridement

Removal of dead tissue

• Surgical (via scalpel)

• Chemical

• Autolitic

  • Let it break down by itself

Skin layers from surface to deep

Stratum corneum > Epidermis > Dermis > Subcut

Skin functions

• Protection

  • Elasticity + Melanin

• Anti-penetration

• Temp reg

• Repair/defenses

  • UV, Vit D, Melanin

• Perception: Nerve receptors

• Absorption & secretion: sebum, cerumen

The Aging Adult

Loss of

• Decreased elastic fibers and adipose tissue

• Decreased collagen → Skin tissue can’t build back up

• Sebaceous activity → Reduces temp control

• Melanocytes: Brown age spot (senile letigines)

• Hair follicles → Declines

  • Bald spot = alopecia

• Nail growth

• Vascularity: Senile purpura

  • Discolored areas

Pallor

Pale

• Anemia, blood loss, anxiety, vasoconstriction

• Blood is diverted when other systems need it

Erythema

Red

• Inflammation, CO poisoning, dilated capillaries, fever

Ecchymosis

Purple

• Damage to soft tissue

Jaundice

• High bilirubin

  • Trying to escape thru skin pores → Yellow skin

  • Damages the brain of children because their brain isn’t fully formed

• Babies have it due to allergies or destruction of hemoglobin

• Liver disease → Liver filters destroyed hemoglobin

Diaphoresis

Excessive sweat unrelated to heat or exercise

Petechiae

Broken capillaries, BAD

Blanching

Checking for capillary refill

Annular

Circular lesion

Macule

Flat, round lesion

Papule

Solid, elevated lesion

Vesicle

Sebum-filled, elevated lesion

Normal elderly skin findings

• Senile lentigines

  • Brown spots

• Keratosis

  • Mistaken for skin cancer, normal for elderly

• Acrochordons

  • Skin tags 

Trachea should be aligned with…

Sternum

Aging Adult’s EYE

• Eyelashes turn inwards (prevent this)

• Presbyopia (Farsightedness)

• Cataracts

• Lens’ yellow and color vision fades

• Distorted depth perception

• Arcus senilus (benign fat around the eye)

Snellen chart test

Letters that get smaller as you move down

Jaeger chart/Rosenbaum

Reading test

Conductive hearing impairment

Clogged, which can lead to balance being affected

Sensorineural hearing impairment

Auditory nerves damaged

Presbycusis

Hearing loss, normal in elderly, usually due to nerve damage

+1 Tonsils

Visible

+2 Tonsils

Halfway to uvula

+3 Tonsils

Touching uvula

+4 Tonsils

Touching each other