Chapter 13 Skin, Hair, and Nails

a newborn infant has down syndrom during the skin assessment, the nurse notices a transient mottling in the trunk and extremities in response to the cool temp in the exam room. the infant's mother also notices and asks the nurse. why?

cutis marmorata

which term would the nurse document in the chart to describe individual lesions that remain separate from each other?

discrete

a patient comes to the clinic and tells the nurse that he has been confined to his recliner chair for approx. 3 days with his feet down and he asks the nurse to evaluate his feet. during the assessment, the nurse might expect to find:

distended veins

The nurse is examining a patient who tells the nurse, "I sure sweat a lot, especially on my face and feet but it doesn't have an odor." Why?

eccrine glands

a child with eczema presents with severe pruritus and weeping vesicles. which additional skin finding would the nurse monitor for?

erythematous papules

the nurse is preparing for a certification course in skin care. correct lesion definitions:

- petichiae: tiny punctate hemorrhages, 1 to 3 mm, round and discrete, dark red, purple, or brown in color - vesicle: known as a friction blister - nodule: solid, elevated, and hard or soft growth that is larger than 1 cm

Which treatment strategy would be beneficial for a child who has a large, dark red macular patch on the right cheek that darkens when crying or experiencing extreme temps?

- photoablation with yellow laser light

Which assessment finding would help the nurse detect erythema in a dark-skinned patient who has polycythemia?

- reddish lips

The nurse educator is preparing an education module for the nursing staff on the epidermal layer of skin. Which of these statements would be included in the module?

- replaced every 4 weeks

Which locations of the body would the nurse assess to confirm jaundice in an a dark-skinned patient?

- sclera - hard/soft palate junction - palms

which locations of the body would the nurse assess to confirm jaundice in a dark-skinned patient?

- sclera - hard/soft palate junction - palms

a patient injured 2 days ago while playing soccer has reddish-brown linear streaks on the toenails. which abnormal nail condition is the patient exhibiting?

- splinter hemorrhages

In which sequence would the child's rash with suspected chickenpox begin?

- starts on the trunk and spreads

Which at-risk persons would the nurse screen closely for skin cancer?

- trains for and runs in marathons - is a farmer - works as a roofer - repairs old furniture as a hobby

when performing an assessment of a 65 y/o man with a history of hypertension and coronary artery disease, nurse notices bilateral pitting edema in the lower legs. skin is puffy and tight but normal in color. no increased redness or tenderness is observed. why?

heart failure

the patient had a red macular rash of the axillae and regional lymphadenopathy because of a tick bite, but the rash disappeared without treatment. which additional questions would the nurse ask?

- do you have fatigue - do you have fever and chills - have you experienced joint or muscle aches

Which skin finding in a newborn would alert the nurse to notify the provider of fetal distress?

- greenish-brown discoloration of the nails and cord

Which medical conditions would the nurse assess for in an infant with excessive sweating?

- hypoglycemia - heart disease - hyperthyroidism

which area would the nurse observe in a patient to determine the presence of cheilosis?

- mouth

findings characteristic of a stage II pressure ulcer

- partial thickness skin erosion is observed with loss of epidermis or dermis - open blister areas have a red-pink wound bed

which condition would the nurse find during the skin assessment of a patient with hyperthyroidism?

hyperthermia

which statement would the nurse expect to hear from a patient who has a depression straight down the middle of the nail?

i have a habit of constantly picking my cuticle

a mother has noticed that her son, who has been to a new babysitter, has some blisters and scabs on his face and buttocks. on exam, the nurse notices moist, thin-roofed vesicles with a thin erythematous base and suspects:

impetigo

which lab finding would the nurse expect in a patient who has a yellowish discoloration of the skin and sclera?

increased serum bilirubin level

a patient has had a "terrible itch" for several months that he has been continuously scratching. on exam, the nurse might expect to find?

lichenification

a patient with possible malignant melanoma reports that a mole has recently changed color. which additional mole change would the nurse monitor for?

light bleeding

which instruction would the nurse include for a patient who has recurrent raised red wheals and pruritic hives from urticaria?

maintain a food diary to ID triggers

A newborn infant is in the clinic for a well-baby checkup. The nurse observes the infant for the possibility of fluid loss bc of which of these factors?

the newborn's skin is more permeable than that of the adult

which statement would the nurse make to a pregnant patient who reports, "on my upper chest i have tiny spots with red in the middle and skinny branches"?

these are common during pregnancy and will disappear after delivery

a 45 y/o farmer comes in for a skin evaluation and complains of hair loss on his head. his hair seems to be breaking off in patches, and he notices some scaling on his head. the nurse suspects:

tinea capitis

which abnormal hair condition would cause the nurse to ask about cancer and chemotherapy treatments?

toxic alopecia

a mother brings her child into the clinic for an examination of the scalp and hair. irregularly shaped patches with broken-off, stublike hair in some places. what is it

trichotillomania, her child probably has a habit of absentmindedly twirling hair

which term would the nurse use to describe the white cheesy substance on the neonate's body?

vernix caseosa

best term to describe excessive dryness of skin

xerosis

the nurse is assessing a patient who has liver disease for jaundice. which of these assessment findings is indicative of true jaundice?

yellow color of the scera that extends up to the iris

which skin color would the nurse expect to observe in a child whose parents have been feeding the child vitamin A supplements regularly?

yellowish-orange

during the aging process, the hair can look gray or white and begin to feel thin and fine. why?

melanocytes

which area would the nurse inspect to determine the presence of koplik spots in a child with suspected measles?

mouth

which assessment finding would alert the nurse that the patient with AIDS has Kaposi sarcoma?

multiple faint pink lesions on the temple and beard area

the nurse is assessing for clubbed fingernails and expects to find:

nail bases with an angle of 180 degrees or greater and nail bases that feel spongy

which information would the nurse include in a teaching sessian about nail physiology?

the pink color is because of vascular epithelial cells

a 65 y/o man with emphysema and bronchitis has come to the clinic for a follow-up appointmetn. on assessment, the nurse might expect to see which finding?

clubbing of the nails

Dehydration. The nurse should test skin mobility and turgor over the infant's:

abdomen

The nurse is bathing an 80 y/o man and notices that his skin is wrinkled, thin, lak, and dry. Why?

an increased loss of elastin and a decrease in subcutaneous fat

When would the nurse begin to assess a newborn for physiologic jaundince?

around the fourth day of life

a physician tells the nurse that a patient's verterbra prominens is tender and asks the nurse to reevaluate in 1 hour. the area:

at the level of the C7 verterba

Which type of primary lesion is superficial in the epidermis, is more than 1 cm in diameter, and ruptures easily?

bulla

which type of primary legion is superficial in the epidermis, is more than 1 cm in diameter, and ruptures easily?

bulla

which finding would the nurse expect to observe when assessing dark-skinned patients?

cherry-red nail beds with carbon monoxide poisoning

a 35 y/o pregnant woman comes to the clinic for a monthly appointment. during teh assessment, the nurse notices that she has a brown patch of hyperpigmentation on the face. why?

chloasma

the nurse keeps in mind that a thorough skin assessment is extremely important because the skin holds information about a person's:

circulatory status

a 70 y/o has liver spots. what causes them?

clusters of melanocytes that appear after extensive sun exposure

a physician has diagnosed a patient with purpura. what is it?

confluent and extensive patch of petechiae and ecchymoses on the feet

The nurse educator is preparing an education module for the nursing staff on the dermis layer of skin. Which of these statements would be included in the module?

contains sensory receptors

a man has come because he has several areas of pigmentation that look greasy, dark, and "stuck on" his skin. why?

seborrheic keratoses, which do not become cancerous

the nurse has discovered decreased skin turgor in a patient and knows that this finding is expected in which condition?

severe dehydration

which statement by the nurse indicates a correct understanding about skin turgor?

skin turgos is affected by extreme weight loss

which skin assessment would the nurse observe in an older adult patient who has senile lentigines?

small, flat brown macules on forearms and hands

which vascular lesion would the nurse look for while assessing a patient who has chronic liver disease?

spider angioma

In which areas would the nurse assess for petechiae in a dark-skinned patient who has subacute bacterial endocarditis?

- buttocks - abdomen - forearm

in which areas would the nurse assess for petechiae in a dark-skinned patient who has subacute bacterial endocarditis?

- buttocks - abdomen - forearm

the nurse notices that a patient has a solid, elevated, circumscribed lesion that is less than 1 cm in diameter. what is it?

papule

which distinctive assessment would the nurse expect to observe in a patient with thrombocytopenia?

petechiae

a patient has been admitted for severe psoriasis. the nurse expects to see what finding in the patient's fingernails?

pitting

which nail condition would a nurse observe in a patient who has paronychia?

red, tender, and swollen nail folds

the nurse notices that a school-aged child has bluish-white, red-based spots in her mouth that are elevated approx 1 to 3 mm. what other signs would the nurse expect to find in this patient?

red-purple, maculopapular, blotchy rash behind the ears and on the face