Skin, Hair, and Nails

Two Layers of the Skin

epidermis and dermis 1. epidermis (outer, highly differential) 2.dermis (Inner, supportive) *Subcutaneous layer of adipose tissue is beneath.

Danger signs of abnormal findings with pigmented lesions: ABCDEF

Asymmetry Border irregularity Color Variation Diameter >6mm Elevation or Evolution Funny looking Additional symptoms: rapidly changing lesion; a new pigmented lesion; development of itching, burning, or bleeding in a mole. *Pallor, erythema, cyanosis, and jaundice.

Which microorganism causes athlete's foot? Tinea pedis Tinea corporis Varicella zoster virus Herpes simplex virus

Athlete's foot is a fungal infection that is caused by tinea pedis, or ringworm of the foot, and is characterized by the presence of small vesicles and fissures between the toes and on the sides of the feet. Tinea corporis, varicella zoster virus , or herpes simplex virus infections do not cause athlete's foot. Tinea corporis is a type of ringworm that affects the body, not the feet. Varicella zoster virus causes chickenpox. Herpes simplex virus causes a cold sore infection, resulting in acute gingivostomatitis.

May be tan to brown in color.

Birthmarks

Which term would the nurse document in the chart to describe individual lesions that remain separate from each other? Discrete Confluent Gyrate Zosteriform

Discrete describes distinct, individual lesions that remain separate from each other. Confluent indicates the lesions have run together. Gyrate indicates a twisted, coiled spiral, or snakelike configuration. Zosteriform is a linear arrangement along a unilateral nerve route.

Small, flat macules of brown melanin pigment that occur on sun-exposed skin

Freckles (Ephelides)

Which are functions of the skin? Select all that apply. Regulates body temperature Regulates blood glucose level Assists in acid-base balance Prevents invasion of microorganisms Assists in the production of vitamin D

Functions of the skin include the following: regulates body temperature, prevents invasion of microorganisms, and assists in the production of vitamin D. Skin helps in thermoregulation by adjusting heat through the sweat glands and subcutaneous insulation. The skin acts as a mechanical barrier that protects the body against peripheral invasions of microorganisms. Ultraviolet rays of the sun fall on the skin, and the sunlight transforms cholesterol into vitamin D. The hormones insulin and glucagon regulate blood glucose. The acid-base balance is regulated inside the body, and the skin does not participate in this process.

A clump of melanocytes, tan-to-brown color, flat or raised.

Mole (Nevus) *Acquired Nevi have symmetry, small size (6mm or less), smooth borders, and single uniform pigmentation.

A patient with possible malignant melanoma reports that a mole has recently changed color. Which additional mole change would the nurse monitor for? Perfectly symmetrical Well-defined margins Smaller than 3 millimeters Light bleeding

Rationale The nurse would monitor for light bleeding. A rapidly changing lesion and development of bleeding in a mole may be an indication of malignant melanoma. In multiple melanoma the mole would be asymmetrical, not symmetrical. The borders are irregular with poorly defined margins (not well-defined margins) in malignant melanoma. The diameter is greater than 6 millimeters, the size of a pencil eraser, in a mole with malignant melanoma.

Which skin structure is altered when a patient reports dryness of the scalp, forehead, face, and chin? Keratin Melanocytes Sebaceous glands Adipose tissue

Sebaceous glands keep the scalp, forehead, face, and chin lubricated. Sebum secreted from the sebaceous gland oils and lubricates the skin and hair and forms an emulsion with water that retards water loss from the skin. Keratin has no function in preventing skin dryness. The epidermis, or the outer layer, is made of tough fibrous protein called keratin. Melanocytes secrete melanin that controls skin color. Adipose tissues are fat deposits interspersed below the skin; they help in thermoregulation and provide protection.

Which statement made by a co-worker indicates a correct understanding of skin structures and functions? "Epidermis is thin, but tough." "Skin is thinner at the palm." "Keratin provides a brown tone to the skin." "The outer layer is mainly made of collagen."

The epidermis is thin but tough. Its cells are bound tightly together into sheets that form a rugged protective barrier. On the palms and soles skin is thicker (not thinner) because of work and weight bearing. Keratin has no function in skin pigmentation. The epidermis, or the outer layer, is made of tough fibrous protein called keratin. The melanocytes intercalated along the basal cell layer produce the pigment melanin, which gives brown tones to the skin. The basal cell layer of the epidermis is mainly made of keratin; the dermis or inner supportive layer consists mostly of connective tissue, or collagen.

Which abnormal hair condition would cause the nurse to ask about cancer and chemotherapy treatments? Tinea capitis Toxic alopecia Tinea versicolor Traction alopecia

The nurse would ask the patient with toxic alopecia about cancer and chemotherapy treatments. The loss of hair that results from cancer and chemotherapy is known as toxic alopecia. The medications prescribed for cancer may inhibit the growth of hair cells, resulting in asymmetric balding or patchy hair loss. Tinea capitis is a fungal infection that results in patchy hair loss with pustules and scales on the scalp; it does not result from cancer or chemotherapy. Tinea versicolor is scaling, round patches of pink, tan, or white (thus the name), distributed in a short-sleeved turtleneck sweater area that is caused by a superficial fungal infection, not cancer or chemotherapy. Traction alopecia is hair loss caused by trauma from tight braiding or tight ponytails, barrettes, cornrows, or hair weaves.

Which assessment finding would the nurse observe in a patient with hirsutism? Circular lesions with clear centers on the abdomen of a child Excessive hair growth on a female's face and chest Thick, yellow-to-white, greasy scales on an infant's scalp Multiple pustules with visible hair in the center on a male's neck

The presence of excessive hair growth on a female's face and chest indicates hirsutism. This condition is caused by improper functioning of the endocrine glands or a metabolic dysfunction. Tinea corporis (ringworm of the body) form multiple circular lesions with clear centers on the abdomen, chest, and back of arms. Seborrheic dermatitis (cradle cap) presents with thick, yellow-to-white, greasy scales with mild erythema on an infant's scalp. Folliculitis barbae (razor bumps) presents with multiple pustules and "whiteheads," with hair visible at the center of an erythematous base, usually on a man's face and neck.

Which patient assessment finding alerts the nurse to a keloid formation at the site of a previous surgery? Area of depressed skin Excess scar tissue Thick, dry exudates Tightly packed papules

The presence of excessive scar tissue beyond the original injury or surgery indicates the patient has a keloid. The presence of depressed skin at the site of the surgery indicates that the patient has an atrophic scar, caused by the loss of tissue. Crusts are the thick, dried exudates left after the bursting of vesicles or pustules. The presence of tightly packed papules at the site of the surgery indicates the patient has lichenification, caused by prolonged or intense scratching.

The complete absence of melanin pigment in patchy areas or white or light skin on the face, neck, hands, feet, and body folds around orfices.

Vitiligo

A patient is devoid of melanin pigment in patchy areas of the skin on the face, neck, hands, feet, and body folds. Which term would the nurse use to describe this condition? Freckles Vitiligo Moles Birthmarks

Vitiligo is an acquired condition characterized by a lack of melanin pigment in patchy areas of the skin on the face, neck, hands, feet, and body folds and around orifices. Dark-skinned people are more susceptible to this condition. Freckles are tiny, flat macules of brown melanin pigment that occur on skin that is frequently exposed to the sun. A mole is a clump of melanocytes that are flat or raised and brown or tan in color. A birthmark is a tan or brown mark that exists from birth.

Functions of the Skin

protection, prevents penetration, perception, temperature regulation, identification, communication, wound repair, absorption and excretion, production of vitamin D.