NU 325 Exam 2 Chamberlain College of Nursing Health Assessment Review Questions &
Answers
1) |Why |is |a |skin |assessment |important? |What |general |information |about |the |body |as |a |whole |is |
obtained |through |a |skin |assessment? |Know |important |issues |to |ask |when |taking |a |history |about |the |
skin. |- |answers- |You |can |gather |clues |about |health |problems |through |the |skin.
- |Information |about |body's |circulation, |nutrition |& |signs |of |systemic |disease.
- |Past |history |of |skin |disease, |change |in |pigmentation/color, |change |in |mole
|size/shape/color/exnderness, |dryness/moisture, |pruritus, |bruising, |rash/lesion, |hair |loss, |change |in |
nails, |etc |& |Rx |medications
Pallor |- |answers- |Extreme |or |unusual |paleness; |skin |takes |color |of |connective |tissue |(collagen); |
common |in |anxiety |or |fear. |
- |Observe |in |mucous |membranes, |lips |& |nail |beds
Erythema |- |answers- |Intense |redness |from |excess |blood |from |dilated |superficial |capillaries
- |Expected |with |fever, |local |inflammation |or |emotional |reactions |in |vascular |flush |areas
Cyanosis |- |answers- |Bluish |discoloration |of |the |skin |resulting |from |poor |circulation |or |inadequate |
oxygenation |of |the |blood.
- |Best |seen |in |lips, |nose, |cheeks, |ears |& |oral |mucous |membranes. |
- |Most |conditions |causing |this |also |cause |decreased |oxygenation |of |the |brain
Jaundice |- |answers- |Yellowing |of |skin; |indicates |rising |amounts |of |bilirubin |in |blood.
- |First |noted |in |junction |of |hard |& |soft |palates |in |mouth |and |in |sclera |of |eye
Technique |used |to |effectively |assess |skin |temperature: |- |answersuse |backs |of |hand |to |palpate |person;
|skin |should |be |warm |and |temperature |should |be |bilaterally |equal
Diaphoresis |- |answers- |profuse |sweating |(perspiration) |- |accompanies |increased |metabolic |rate
- |can |indicate |anxiety, |pain |or |low |BP
Dehydration |- |answers- |A |serious |reduction |in |the |body's |water |content
- |dry |mucous |membranes, |lips, |decreased |skin |turgor
How |to |assess |for |skin |turgor |- |answers- |Infants: |test |mobility |of |skin |over |abdomen
- |Adults: |punch |a |large |fold |of |skin |on |anterior |of |chest |under |clavicle |
- |Can |be |affected |by |dehydration, |extreme |weight |loss |and |age
, Why |is |an |infant |more |susceptible |to |dehydration? |- |answers- |Higher |body |water |content |along |with |
higher |metabolic |rates |
- |They |require |greater |volumes |of |water |to |maintain |fluid |equilibrium
- |Skin |is |thin, |smooth |& |elastic |therefor |much |more |permeable |than |an |adult's
Papule |- |answers- |small |(less |than |1 |cm |in |diameter), |solid, |raised |lesion |on |surface |of |the |skin
- |something |you |can |feel
- |caused |by |superficial |thickening |of |dermis
ex: |mole, |wart
Nodule |- |answers- |solid, |round |or |oval |elevated |lesion |1 |cm |or |more |in |diameter
- |may |extend |deeper |into |dermis |than |papule
Tumor |- |answers- |larger |than |a |few |centimeters |in |diameter |
-firm |or |soft
- |deeper |into |dermis; |may |be |benign |or |malignant
Wheal |- |answers- |superficial, |raised, |transient, |and |erythematous
- |slightly |irregular |shape |from |edema
Pustule |- |answersraised |spot |on |the |skin |containing |pus
Danger |sign |of |lesions |- |answers- |Asymmetry: |not |regularly |round |or |oval
- |Border |Irregularity: |ragged |edges
- |Color |variation: |areas |of |brown, |tan, |black, |blue, |red |or |combination
- |Diameter: |greater |than |6 |mm |
- |Elevation/enlargement
Skin |developmental |considerations: |Infant |- |answersnewborns |with |brown/black |skin |have |lighter |skin
|tone |than |parents |because |of |immature |pigment |formation; |full |melantonic |color |event |in |nail |beds |
& |scrotal |folds
Skin |developmental |considerations: |Adolescence |- |answers- |increased |sebaceous |gland |activity |which |
creates |oiliness |and |acne
- |acne |lesions |may |appear |as |early |as |7-8 |years |and |peak |at |14-17 |in |girls |and |16-19 |in |boys.
- |facial |hair |appears |on |boys |first |on |lip, |then |cheeks |and |below |lip, |last |on |chin
- |noticeable |enlargement |of |thyroid |cartilage |causing |deeper |voice
Answers
1) |Why |is |a |skin |assessment |important? |What |general |information |about |the |body |as |a |whole |is |
obtained |through |a |skin |assessment? |Know |important |issues |to |ask |when |taking |a |history |about |the |
skin. |- |answers- |You |can |gather |clues |about |health |problems |through |the |skin.
- |Information |about |body's |circulation, |nutrition |& |signs |of |systemic |disease.
- |Past |history |of |skin |disease, |change |in |pigmentation/color, |change |in |mole
|size/shape/color/exnderness, |dryness/moisture, |pruritus, |bruising, |rash/lesion, |hair |loss, |change |in |
nails, |etc |& |Rx |medications
Pallor |- |answers- |Extreme |or |unusual |paleness; |skin |takes |color |of |connective |tissue |(collagen); |
common |in |anxiety |or |fear. |
- |Observe |in |mucous |membranes, |lips |& |nail |beds
Erythema |- |answers- |Intense |redness |from |excess |blood |from |dilated |superficial |capillaries
- |Expected |with |fever, |local |inflammation |or |emotional |reactions |in |vascular |flush |areas
Cyanosis |- |answers- |Bluish |discoloration |of |the |skin |resulting |from |poor |circulation |or |inadequate |
oxygenation |of |the |blood.
- |Best |seen |in |lips, |nose, |cheeks, |ears |& |oral |mucous |membranes. |
- |Most |conditions |causing |this |also |cause |decreased |oxygenation |of |the |brain
Jaundice |- |answers- |Yellowing |of |skin; |indicates |rising |amounts |of |bilirubin |in |blood.
- |First |noted |in |junction |of |hard |& |soft |palates |in |mouth |and |in |sclera |of |eye
Technique |used |to |effectively |assess |skin |temperature: |- |answersuse |backs |of |hand |to |palpate |person;
|skin |should |be |warm |and |temperature |should |be |bilaterally |equal
Diaphoresis |- |answers- |profuse |sweating |(perspiration) |- |accompanies |increased |metabolic |rate
- |can |indicate |anxiety, |pain |or |low |BP
Dehydration |- |answers- |A |serious |reduction |in |the |body's |water |content
- |dry |mucous |membranes, |lips, |decreased |skin |turgor
How |to |assess |for |skin |turgor |- |answers- |Infants: |test |mobility |of |skin |over |abdomen
- |Adults: |punch |a |large |fold |of |skin |on |anterior |of |chest |under |clavicle |
- |Can |be |affected |by |dehydration, |extreme |weight |loss |and |age
, Why |is |an |infant |more |susceptible |to |dehydration? |- |answers- |Higher |body |water |content |along |with |
higher |metabolic |rates |
- |They |require |greater |volumes |of |water |to |maintain |fluid |equilibrium
- |Skin |is |thin, |smooth |& |elastic |therefor |much |more |permeable |than |an |adult's
Papule |- |answers- |small |(less |than |1 |cm |in |diameter), |solid, |raised |lesion |on |surface |of |the |skin
- |something |you |can |feel
- |caused |by |superficial |thickening |of |dermis
ex: |mole, |wart
Nodule |- |answers- |solid, |round |or |oval |elevated |lesion |1 |cm |or |more |in |diameter
- |may |extend |deeper |into |dermis |than |papule
Tumor |- |answers- |larger |than |a |few |centimeters |in |diameter |
-firm |or |soft
- |deeper |into |dermis; |may |be |benign |or |malignant
Wheal |- |answers- |superficial, |raised, |transient, |and |erythematous
- |slightly |irregular |shape |from |edema
Pustule |- |answersraised |spot |on |the |skin |containing |pus
Danger |sign |of |lesions |- |answers- |Asymmetry: |not |regularly |round |or |oval
- |Border |Irregularity: |ragged |edges
- |Color |variation: |areas |of |brown, |tan, |black, |blue, |red |or |combination
- |Diameter: |greater |than |6 |mm |
- |Elevation/enlargement
Skin |developmental |considerations: |Infant |- |answersnewborns |with |brown/black |skin |have |lighter |skin
|tone |than |parents |because |of |immature |pigment |formation; |full |melantonic |color |event |in |nail |beds |
& |scrotal |folds
Skin |developmental |considerations: |Adolescence |- |answers- |increased |sebaceous |gland |activity |which |
creates |oiliness |and |acne
- |acne |lesions |may |appear |as |early |as |7-8 |years |and |peak |at |14-17 |in |girls |and |16-19 |in |boys.
- |facial |hair |appears |on |boys |first |on |lip, |then |cheeks |and |below |lip, |last |on |chin
- |noticeable |enlargement |of |thyroid |cartilage |causing |deeper |voice
