HA Chapter 14 Skin, Hair, Nails

Small pits in the nails are an early sign of, though not specific for, psoriasis.

A 23-year-old woman has presented to the clinician to follow up her recent diagnosis of psoriasis. Which of the following assessments of the client's nails would be consistent with the client's diagnosis?

Tinea corporis (ring worm)

A 4-year-old child presents to the health care clinic with circular lesions. Which of the following conditions should the nurse most suspect in this client, based on the configuration of the lesions?

Malignant melanoma

A client visits the clinic for a routine physical examination. The nurse prepares to assess the client's skin. The nurse asks the client if there is a family history of skin cancer and should explain to the client that there is a genetic component with skin cancer, especially?

Eczema

Also known as atopic dermatitis, is characterized by itchy, pink macular or papular lesions, commonly located on flexural areas such as the inner elbows or posterior knees. Can occur anywhere on the body.

Iron deficiency anemia

Associated with spoon-shaped nails

The epidermis

Composed of four distinct layers: the stratum corneum, stratum lucidum, stratum granulosum, and stratum germinativum. The outermost layer consists of dead, keratinized cells that render the skin waterproof.

Vesicular lesions

Example of what lesion? Varicella and herpes simplex

Cushing's disease and results from an imbalance of adrenal hormones.

Hirsutism, or facial hair on females, is a characteristic of?

Fissures

Linear cracks in the skin that may extend to the dermis and may be painful. Examples include chapped lips or hands and athlete's foot.

A decrease of sebum secreted by sebaceous glands occurs with age and results in drier hair.

The nurse expects what change in a client's hair as a result of aging?

Consider admitting the client to the hospital. Although this rash may not be impressive, the fact that they do not blanch with pressure is concerning. This generally means that there is pinpoint bleeding under the skin; while this can be benign, it can be associated with life-threatening illnesses like meningococcemia and low platelet counts (thrombocytopenia) associated with serious blood disorders like leukemia. The nurse should always report this feature of a rash immediately.

A 14-year-old boy has a rash at his ankles. There is no history of exposures to ill people or environmental agents. He has a slight fever. The rash consists of small, bright red marks. When they are pressed, the red colour remains. What should the nurse do?

If the client has a specific concern about the skin, the nurse should inspect the area/lesion first and ask other questions second.

A client tells the nurse about a raised lesion on the client's leg. What is the nurse's first nursing action?

Patchy hair loss may accompany infections, stress, hairstyles that put stress on hair roots, and some types of chemotherapy.

An adult male client visits the outpatient center and tells the nurse that he has been experiencing patchy hair loss. The nurse should further assess the client for

Contact dermatitis

An inflammatory response to an antigen that has contact with exposed skin. Initial contact causes stimulation of the histamine receptors, which results in the classic erythematous and pruritic lesions.

Seborrhea

An inflammatory skin disorder characterized by macular lesions that may be pink, red, or orange-yellow and may or may not have a fine scale. Distribution is usually on the face, scalp, and ears.

The apocrine glands

Are found chiefly in the axillary and genital regions, usually open into hair follicles, and are stimulated by emotional stress. This type of gland does not secret on locations identified by the other options.

Psoriasis

Characterized by reddish-pink lesions covered with silvery scales. It commonly occurs on extensor surfaces such as the elbows and knees but can appear anywhere on the body.

Chronic hypoxia

Clubbing of the nails indicates? Clubbing is identified when the angle of the nail to the finger is more than 160 degrees.

A secondary lesion

Emerges from an existing primary lesion, such as the keloids that can emerge from the site of a healed wound.

Pustular lesions

Example of what lesion? Acne, furuncles and carbuncles

hypothyroidism

Generalized hair loss may be seen in various systemic illnesses such as ___________________________________ and in clients receiving certain types of chemotherapy or radiation therapy.

Patchy hair loss

Lupus erythematosus causes:

This is a typical case of urticaria

Mrs. Anderson presents with an itchy raised rash that appears and disappears in various locations. Each lesion lasts for many minutes. Which most likely accounts for this rash? The most unusual aspect of this condition is that the lesions move from place to place.

Beau's lines

Occur after acute illness and eventually grow out.

Psoriasis

Parents bring a child to the clinic and report a "rash" on her knee. On assessment, the nurse practitioner notes the area to be a reddish-pink lesion covered with silvery scales. What would the nurse practitioner chart?

Plaque lesions

Psoriasis is an example of what lesion?

While monthly self-examination and awareness of signs of skin cancer may aide in early detection, only avoiding sun will prevent and protect against skin cancer. Clinical examinations are recommended annually.

Recommended protective measures to avoid skin cancer include which of the following?

Vellus

Short, pale, and fine hair that is present over much of the body is termed

Pulse oximetry A nail angle greater than 160 degrees indicates clubbing which is caused by chronic hypoxia. Measuring the client's pulse oximetry would be a priority.

The nurse notes that a client's nails are greater than a 160-degree angle. What should the nurse assess as a priority for this client?

50 years

The risk for melanoma is increased in people older than?

Ashen

To assess for anemia in a dark-skinned client, the nurse should observe the client's skin for a color that appears. Pallor (loss of color) is seen in arterial insufficiency, decreased blood supply, and anemia. Pallid tones vary from pale to ashen without underlying pink.

Dermis

Well-vascularized, connective tissue layer containing collagen and elastic fibers, nerve endings, and lymph vessels. It is also the origin of sebaceous glands, sweat glands, and hair follicles.

The nurse should inspect the area under the breast for skin integrity in obese clients. The area between the skin folds is more prone to loss of skin integrity; therefore, the presence of skin breakdown should be inspected on the skin on the limbs, under the breasts, and in the groin area. Perspiration and friction often cause skin problems in these areas in obese clients.

Which area of the body should a nurse inspect for possible loss of skin integrity when performing a skin examination on a female who is obese?