King Saud University College of Nursing Adult Nursing (NUR 316)

1. King Saud UniversityCollege of NursingAdult Nursing (NUR 316) Skin, hair, and nail assessment

2. Integumentary System • Skin and accessory structures • Hair • Nails

3. Skin • Largest Organ of the Body • Protection from environment • Temperature regulation • Synthesis of vitamin D • Storage of fat and blood • Excretion of waste • Sensation • Composed of the Epidermal and Dermal Layers

4. Figure 11.1 Skin structure. Three-dimensional view of the skin, subcutaneous tissue, glands, and hairs.

5. The Major Functions of the Skin • Perceiving touch, pressure, temperature, and pain via the nerve endings • Protecting against mechanical, chemical, thermal, and solar damage • Protecting against loss of water and electrolytes • Regulating body temperature

6. The Major Functions of the Skin • Repairing surface wounds through cellular replacement • Synthesizing vitamin D • Allowing identification through uniqueness of facial contours, skin and hair color, and fingerprints

7. Oil or Sebaceous Glands • Produce Sebum That Is Usually Released in Hair Follicles

8. The Major Functions of the Cutaneous Glands • Excreting uric acid, urea, ammonia, sodium, potassium, and other metabolic wastes • Regulating temperature through evaporation of perspiration on the skin surface • Protecting against bacterial growth on the skin surface

9. The Major Functions of the Cutaneous Glands • Softening, lubricating, and waterproofing skin and hair • Resisting water loss from the skin surface in low-humidity environments • Protecting deeper skin regions from bacteria on the skin surface

10. Hair • Thin Fiber Compound of Dead Keratinized Cells • Vellus • Terminal

11. Nails • Thin Plates of Keratinized Epidermal Cells That Cover the Distal Ends of Fingers and Toes

12. Figure 11.2 Structure of a nail.

13. Focused Interview • General questions

14. Specific Questions • Illness or infection • Symptoms • Pain • Behaviors • Infants and children • Pregnant females • Older adults • Environment

15. Box 11.2 Self-Examination of the Skin

16. Removal of: • Clothing • Jewelry • Cosmetics • Wigs • Hairpieces

17. Abnormal Skin Findings • Primary and secondary lesions • Vascular lesions • Purpuric lesions • Infections • Malignant lesions • ABCDE Criteria

18. Figure 11.22 ABCDE Criteria for Melanoma Assessment

19. Table 11.2 Potential Secondary Sources for Client Data Related to the Skin, Hair, and Nails

20. Figure 11.29 Spoon nail.

21. Figure 11.30 Hemangioma.

22. Figure 11.31 Port-wine stain (nevus flammeus).

23. Figure 11.32 Spider (star) angioma.

24. Figure 11.33 Venous lake.

25. Figure 11.34 Petechiae.

26. Figure 11.35 Purpura.

27. Figure 11.36 Ecchymosis (bruise).

28. Figure 11.37 Hematoma.

29. Figure 11.38 Macule and patch.

30. Figure 11.39 Papule and plaque.

31. Figure 11.40 Nodule and tumor.

32. Figure 11.41 Vesicle and bulla.

33. Figure 11.42 Wheal.

34. Figure 11.43 Pustule.

35. Figure 11.44 Cyst.

36. Figure 11.45 Atrophy.

37. Figure 11.46 Erosion.

38. Figure 11.47 Lichenification.

39. Figure 11.48 Scales.

40. Figure 11.49 Crust.

41. Figure 11.50 Ulcer.

42. Figure 11.51 Fissure.

43. Figure 11.52 Scar.

44. Skin Lesions • Tinea • Measles • Varicella • Herpes • Psoriasis • Dermatitis • Eczema • Impetigo

45. Figure 11.63 Tinea corporis.

46. Figure 11.64 Measles (rubeola).

47. Figure 11.65 German measles (rubella).

48. Figure 11.66 Chickenpox (varicella).

49. Figure 11.67 Herpes simplex.

50. Figure 11.68 Herpes zoster (shingles).