ealthupshot is your one platform destination to satiate your brain cells as well as your heart with an array of unheard stories in Entertainment, Lifestyle, Food Factory, Fashion, Beauty and not to forget the social responsibility via Social Spotlight. https://www.slideshare.net/

1. Assessment of Skin, Hair and Nails

2. Structure of the Integument
 The skin is the largest organ of the body comprising 15 percent of
total body weight.
 Layers of the skin
A. Epidermis B. Dermis C. Subcutaneous
tissue
Epidermal appendages
 Hair
 Nails
 Glands: two types of skin glands:
1. Sweat Gland
Eccrine sweat glands: are widely distributed and open
directly onto the skin surface
Apocrine sweat glands: open into hair follicle in axillary and
genital areas
2. Sebaceous glands: Produce sebum(oily secretion)
 https://www.healthupshot.com/

3. 3

4. Functions of skin and epidermal appendages
 Barrier to water and electrolyte loss
 Regulation of body heat
 Sensory organ for touch, temperature, and Pain
 Production of protective skin film by eccrine and
sebaceous glands
 Participation in production of vitamin
 Wound repair
https://www.healthupshot.com/
4

5. Assessing the Integument
1. Subjective data
 Skin infection, rashes, lesions, itching.
 Precipitating factors: stress, weather, drugs
 Changes in skin color, lesions
 Amount of sun exposure
 Scalp lesions, itching, and infections.
 Changes in texture and amount of hair.
 Changes in nails and cuticles nail breaking
https://www.healthupshot.com/
5

6. 2. History of current symptom
 Are you having experience of skin problem, such as
rashes, lesion
 Describe any birthmarks, tattoos, or moles
 Have you noticed any changed in your ability to feel
pain, pressure, light touch, or temperature changed?
 Have you had any hair loss or change in the condition
of your hair?
 Have you had any change in the condition or
appearance of your nails?
 Describe any previous problem within the skin, hair or
nails ( past history)
 Have you ever had any allergic skin reaction to food,
medication, plants?
 Has anyone in your family had a recent illness, rash, or
other skin problem? (Family history)

7. 3. Physical Assessment
 Equipment
Penlight Tongue depressor Centimeter rule
Gloves
Magnifying glass Flashlight Wood’s lamp
 Technique to examination of skin
Inspection Palpation
Inspections and palpation of skin
Color Moisture Temperature
Thickness
Turgor Vascular changes Edema
Lesions
Skin odors are usually noted in the skin fold.
https://www.healthupshot.com/
7

8. 8

9. Inspection color of skin
 Skin color varies from body part to body part and from
person to person.
 Assessment first involves area of skin not exposed to the
sun e.g. palms of the hands.
 Pallor easily perceived in the buccal “mouth” mucosa
particularly in individuals with dark skin.
 Cyanosis readily seen in area of least pigmentation e.g.
lips, nail beds conjunctiva and palm.
 Jaundice or Yellow seen in client’s sclera.
 Erythema may indicate circulatory changes
https://www.healthupshot.com/
9

10. 10

11. Palpation moisture of skin
 Skin is normally smooth and dry.
 Skin folds e.g. axillae are normally moist.
 In presence of lesions or ooze fluid, nurse must wear
gloves to prevent exposure to infections drainage
 Moisture indicates:
1- Degree of client’s hydration
2- Condition of the outer lipid layer of the skin
surface
Dry (xerosis): Vitamin A def. and Myxedema
Oily: Acne
https://www.healthupshot.com/
11

12. Palpation of Temperature
 Temperature of skin depends on the amount of blood
circulating through dermis.
 Generalized warmth: (Fever, Hyperthyroidism)
 Local warmth: (Inflammation)
 Coolness: (Hypothyroidism, Frost bite, Hypothermia, Shock,
Low cardiac output)
 Palpation of skin with dorsum of the hand.
 Assessment of skin is critical point in some conditions such
as: after cast application, or after vascular surgery.
https://www.healthupshot.com/
12

13. Palpation of Texture
 Texture of skin normally smooth, soft and flexible
 If any abnormalities in texture found you must ask the
client is he exposed to any recent injury to the skin?
 Nurse determines whether the client’s skin is smooth
or rough, thin or thick, tight or supple (flexible).
 Very Soft: (Thyrotoxicosis)
 Tight: (Scleroderma = hard skin)
 Rough: (Hypothyroidism)
https://www.healthupshot.com/
13

14.  Turgor: is the skin elasticity
diminished by edema or
dehydration.
 Assessment of turgor done
by pinching skin between
the thumb and forefinger
and released.
 Normally skin return
immediately to its position.
 Failure of this process
means dehydration.
 Decrease in turgor
predisposes the client to
skin breakdown.

15. Palpation of Vascularity
 Vascularity: Assessment of circulation of skin E.g. petechiae may
indicate serous blood clotting disorders, drug reactions or liver
disease.
Inspection and Palpation of Edema
 Edema : "Build up of fluid in tissues“
 Inspected for location, color, and shape.
 Palpates areas of edema to determine mobility, consistency, and
tenderness
Inspection and Palpation of Lesions
 Normally skin free of lesions except common freckles.
 If lesion present, inspection must done for distribution,
arrangement, morphology, color and size
 Palpation for lesion’s mobility, contour (flat, raised or depressed)
and consistency (soft or hard are indicated).
 Cancerous lesions frequently undergo changes in color and size.

16. Hair and Scalp
 Assessment done for distribution, thickness, texture, and
lubrication of the hair.
 Some events which affect the distribution of hair over the
body e.g. client with hormone disorders, woman with
hirsutism
 Amount of hair covering extremities may be reduced as a
result of aging and arterial insufficiency especially in lower
limbs.
 Scaliness or dryness of the scalp is frequently caused by
dandruff or psoriasis.
16

17.  Nails reflect an individual's
general state of health, state
of nutrition, and occupation.
 Nails are normally
transparent, smooth, and
convex, with a nail bed angle
of about 160 degrees.
 The surrounding cuticles are
smooth, intact and without
inflammation.
 Nail bed is normally firm on
palpation.
 Nails normally grow at a
constant rate.

18. Abnormal condition of nail
 Anonychia: complete absence of nails
 Platunychia: flatting nails
 Koilonychia : nails like spoon shape (iron deficiencies anemia)
 Racket nail: fattened and expanded nails
 Onycholysis: separation of nail form nail bed (thyrotoxicosis)
 Melanoychia: presence of brown color in nails plate
 Paronychia: inflammation of tissue surrounding the nail
https://www.healthupshot.com/
18

19. 19