SKIN, HAIR AND NAIL ASSESSMENT

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SKIN, HAIR AND NAIL ASSESSMENT
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Skin, hair, and nails

• Structure and function review
• Subjective data ask
• Objective data inspect and palpate

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Structure and Function

• Skinthree layers
• 1. Epidermis
• Stratum germinativum or basal cell layer
• Stratum corneum or horny cell layer
• Derivation of skin color
• 2. Dermis
• Connective tissue or collagen
• Elastic tissue
• 3. Subcutaneous layer

• Epidermal appendages
• 1. Hair
• 2. Sebaceous glands
• 3. Sweat glands
• Eccrine glands
• Apocrine glands
• 4. Nails

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Subjective data

• Page 225-227
• Symptom analysis
• Generalized vs local changes

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Objective DataInspect and palpate skin

• Color
• Hypo- and hyperpigmentation
• Vitiligo
• Macules
• Nevi
• ABCDE evaluation
• Color changes
• Pallor, erythema, cyanosis, jaundice

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Inspect and palpate skin

• Temperature
• - Hypothermia
• - Hyperthermia
• Moisture
• Diaphoresis
• Dehydration
• Texture
• Thickness

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Inspect and palpate skin

• Edema
• Rating scale
• Turgor
• Vascularity/bruising
• Lesions

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Inspect and palpate hair and nails

• Hair
• Color
• Texture
• Distribution
• Lesions scalp
• Nails
• Shape and contour
• Clubbing
• Consistency
• Color
• Capillary refill

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Promoting health - education

• Teach skin self-exam
• ABCDE

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Cultural variations

• Pigmentation
• Hair
• Eccrine apocrine glands

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Changes in the Elderly

• Thinner and flatter
• Dry
• At risk for skin disease breakdown
• Hair

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Summary

• Checklist and application page 246