APC: Hair, Skin, Nails Exam

changes, itching, cancer, skin, sunscreen

Questions to Ask Regarding Growths on the Skin

-Have you noticed any ______ in your hair/skin/nails?

-Have you noted any sores, lumps, or _________?

-Ask about the patient’s personal and family history of skin _______, regular self _____ examination practices, and if they use __________

itch, allergies, wake, dry skin

Questions to Ask Regarding Rash

-Does the rash _____?

-Does itching precede rash or occur after?

-Any history of seasonal _________?

-Does the itching ____ the patient up at night?

-Use of moisturizer, over the counter products

-Any history of ___ ____?, which is a common cause of general itching without rash

thinning, where, heating

Questions to Ask Regarding Hair Loss / Nail Changes

-Is there any hair _________ or shedding?

-_____ is it? Does the hair come out at the root or shaft?

-What are the patient’s hair care practices?

-How often do they shampoo their hair?

-Do they use dyes, chemical relaxers, or ________ appliances?

melanoma, cannot, avoid, sunscreen

Skin Cancer Prevention

-Most common type of skin cancer is basal cell carcinoma

-Goal is to prevent ________, which is the least common and most deadly skin cancer

-Melanoma risk tool can be used to assess the patient’s 5 year risk. ________ be used in patients with family history

-Educate patients to ________ tanning bed and UV radiation and to use __________ regularly

50, history, melanoma, ABCDEFG, exams

Skin Cancer Screening

-Recommended in patients > __ years and those who are high risk, meaning they have a personal/family _______ of multiple or dysplastic nevi or previous ________

-Apply _______ method for screening

-Encourage patients to perform self-skin _______

Asymmetry

The A in ABCDEFG stands for _________, meaning one half of the spot is unlike the other half

Border

The B in ABCDEFG stands for ________, meaning the spot has an irregular, scalloped, or poorly defined border

Color

The C in ABCDEFG stands for _______, meaning the spot has varying colors from one area to the next such as shades of tan, brown, black, white, red, or blue

Diameter

The D in ABCDEFG stands for ________, which is the size of the spot greater than 6 mm but can also be smaller

Evolving

The E in ABCDEFG stands for _________, meaning the spot looks different from the rest or is changing in size/shape/color

Firmness, growing

The F in ABCDEFG stands for ________, while the G stands for _________

all, general, back, chaperone

Techniques of Examination

-Inspect and palpate ___ skin lesions

-Incorporate the skin exam into your _________ physical exam, especially the back and the legs where the patient cannot visualize

-Ensure adequate lighting

-Wash your hands

-Have your tools ready

-Have the patient in a gown with opening at the ____

-Ask patient if they would like a __________, especially if you are going to be dealing with sensitive areas

Same

Perform the skin exam in the _____ order every time

Hair loss

To examine a patient with ____ ___, you can determine the overall pattern for hair loss/thinning, inspect the scalp, and do the hair pull test

bed-bound, pressure

When examining a ___-____ patient, examine them for _______ sores. The areas at risk are the sacrum, buttocks, greater trochanters, knees, and heels