Secondary Skin Lesions, Interview Techniques, and Health History (Notes)

Flashcards cover secondary skin lesions, wound healing outcomes, interviewing techniques, pain assessment (PQRST), chief complaint quality, health history documentation, LEP considerations, and related patient education concepts from the lecture notes.

What defines a secondary skin lesion?

A lesion that forms as a result of healing a primary lesion (e.g., scar, scale, fissure, erosion, ulcer, excoriation, keloid).

Name two secondary skin lesions that may form after healing a vesicle or papule.

Scar and scale (others include fissure, erosion, or ulcer depending on healing).

What is a fissure?

A crack in the surface of the skin.

What is an erosion?

A shallow, scooped-out depression where the top layer of skin is missing; heals without scarring.

What is an ulcer?

A deeper skin loss that extends into the dermis; heals with scarring.

What is a scar?

Permanent thickening or hardening of tissue after healing.

What is lichenification?

Thickening and roughening of the skin from chronic scratching, often with raised, darker patches (eczema/psoriasis).

What is a scale?

Thickened desiccated shedding skin—dry patches.

What is excoriation?

Self-inflicted scratch marks on the skin, superficial and shallow.

What is a keloid?

Excess scar tissue that extends beyond the original wound and may protrude.

What are petechiae?

Tiny red or reddish-purple spots caused by minor bleeding from broken capillaries.

What are purpura?

Larger patches formed when several petechiae coalesce into confluent areas.

What is ecchymosis?

Bruising; bleeding under the skin from broken vessels, not necessarily from external trauma.

What is a contusion?

Bruise resulting from blunt force trauma to the skin's surface.

What skin injury can result from wearing oxygen tubing, and how is it prevented?

Oxygen tubing can rub the ears and nares causing pressure ulcers; prevention includes cushioning with gauze and repositioning tubing.

What is the purpose of the health interview in assessment?

To collect subjective data and identify client concerns before the physical exam; sets direction for the assessment.

What is facilitation in interviewing?

Techniques to help the patient talk, such as clarifying questions and prompting for more detail.

What is the role of silence during an interview?

It allows processing time; maintain eye contact to show engagement.

What is reflection in interviewing?

Restating or paraphrasing what the patient said to confirm understanding.

What is empathy in interviewing?

Showing understanding and being present; validate feelings without shifting the focus to yourself.

What is clarification in interviewing?

Simplifying information and confirming understanding by asking the patient to restate.

What is confrontation in interviewing?

Politely pointing out inconsistencies in what the patient has said.

What is interpretation in interviewing?

Making an inferred connection between symptoms and potential causes; verify with the patient.

What is explanation in interviewing?

Providing information about a condition or medication when the patient asks.

What is summary in interviewing?

Concluding the interview by summarizing findings and next steps.

What are common interviewing traps to avoid?

False reassurance, giving unsolicited advice, using authority, avoidance language, leading questions.

How should LEP (Limited English Proficiency) situations be handled?

Use a facility interpreter (not a family member) to protect confidentiality and ensure accuracy; this complies with civil rights and HIPAA considerations.

What is teach-back?

Have the patient explain or demonstrate back what you taught to confirm understanding.

What is health literacy?

The ability to understand health information and follow instructions; many patients have low health literacy; use plain language and teach-back.

What is the PQRST mnemonic used for pain assessment?

Provocative/palliative, Quality, Region, Severity, Timing; plus Understanding to gauge the pain and its impact on daily living.

What makes a good chief complaint?

A statement that specifies the location, onset, duration, and factors that worsen or relieve symptoms (e.g., chest pain worse with activity, relieved by rest).

What are the eight critical characteristics of pain to document?

Location/region, quality, intensity/severity, onset, duration, timing/frequency, aggravating/provoking factors, relieving/palliating factors, and effect on activities of daily living.

What does the health history documentation require regarding patient identity?

Use initials only and avoid disclosing identity; maintain confidentiality.

What should you consider when submitting the comprehensive health history assignment to CORE?

Each student must submit their own report (even when working with a partner); ensure both upload and submit using two submission steps as required.

What should you do to make the health history interview accessible to older adults?

Allow extra time, speak slowly and clearly, ensure hearing/listening accommodations, address by surname, and be mindful of longer memories and stories.