Fundamentals Exam 2
Chapters: 4, 5, 27, 28, 31, 32, 39, and 48
Protection & Adaptation – Integumentary System
Overview
The skin is the body’s largest organ, comprising 15% of the total body weight.
The skin (1)
...
Fundamentals Exam 2
Chapters: 4, 5, 27, 28, 31, 32, 39, and 48
Protection & Adaptation – Integumentary System
Overview
The skin is the body’s largest organ, comprising 15% of the total body weight.
The skin (1) acts as a protective barrier against disease-causing organisms, (2) is a
sensory organ for pain, temperature, and touch, and (3) synthesizes vitamin D.
Injury to the skin poses risks to safety and triggers a complex healing response.
Knowing the normal healing pattern will assist in recognizing alterations that require
intervention.
Integumentary System
Refers to skin, hair, scalp, nails
Begin with health history (subjective data)
Followed by the physical examination (objective data) – visible surfaces
Sight, smell, and touch – inspection and palpation
Patient’s health status – oxygenation, circulation, nutrition, local tissue damage, and
hydration
Integumentary Assessment
Adequate lighting
Equipment - gloves, penlight, and small centimeter ruler
Room temperature
Inspection
Skin odors
Subjective Data
Health History Questions – Table 31-7, 31-10, 31-11
o Past history of skin disease, allergies, hives, psoriasis, or eczema?
o Change in pigmentation or color?
o Change in mole size, shape, color, tenderness?
o Excessive dryness or moisture?
o Pruritus or skin itching?
o Excessive bruising?
o Rash or lesions?
o Medications: prescription and over-the-counter?
o Hair loss?
o Change in nails’ shape, color, or brittleness?
o Environmental or occupational hazards?
o Self-care behaviors?
Additional history for infants and children
o Does child have any birthmarks?
o Any change in skin color as a newborn?
Physiologic jaundice?
Cyanosis?
o Does child have any rash or sores?
o Does child have diaper rash?
o Does child have any burns or bruises?
Where?
How did it happen?
o Has child been exposed to:
Contagious skin conditions: scabies, impetigo, lice?
Communicable diseases: measles, chicken pox, scarlet fever?
Toxic plants: poison ivy?
o Does child have habits such as nail biting or twisting hair?
o What steps are taken to protect child from sun exposure?
Additional history for adolescents
o Skin problems such as pimples, blackheads?
Additional history for aging adults
o What changes have you noticed in your skin in last few years?
o Any delay in wound healing?
o Any change in feet: toenails; bunions, wearing shoes?
o Falling: bruises, trauma?
o History of diabetes or peripheral vascular disease?
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