SAS 7

• The purpose of the integumentary history is to identify diseases of the skin, systematic diseases that have skin manifestations, physical abuse, risk for pressure ulcer formation, risk for skin cancer, and need for health promotion education regarding the skin.
• Common or concerning symptoms to ask about during the integumentary history include rash, non-healing lesions, moles, lesions, bruising (ecchymosis), and hair loss.
• Skin color varies according to genetic background and may have fair, olive, tan, brown, or golden hues.
• Patients may notice a change in their skin color before the nurse does.
• During the physical examination of the skin, note the color, look for increased pigmentation, loss of pigmentation, or redness of the skin, and assess for cyanosis or pallor.
• Cyanosis is best identified in the lips, oral mucosa, and tongue.
• The instructor will instruct students to write 3 important things they learned from today’s session.
• After the students have completed the task, the instructor will call 3-5 students to share and read out loud the things they have learned from the session.
• Cyanosis in congestive heart failure is usually peripheral, reflecting decreased blood flow, but in pulmonary edema, it may also be central.
• Venous obstruction may cause peripheral cyanosis.
• The functions of the integumentary system include protection, sensory perception, thermoregulation, and vitamin D synthesis.
• Risk factors for pressure ulcers include diseases of the skin, systematic diseases that have skin manifestations, physical abuse, risk for skin cancer, and need for health promotion education regarding the skin.
• The layer of the skin that consists of adipose tissue is the Dermis.
• Excessive intake of yellow or orange colored fruits and vegetables can lead to carotenemia.
• The best site for the assessment of skin turgor is at the abdomen.
• Loss of oxygen from the skin can lead to jaundice.
• The nurse suspects a disorder in the liver if a patient has a jaundiced skin.
• The skin does several mechanisms to regulate the body temperature, including the release of catecholamines, vasodilation, release of pyrogens, and vasoconstriction.
• Melanocytes are the cells responsible for the skin color of a person.
• Tinea versicolor is caused by an infection of fungi.
• The integumentary system regulates the body temperature, serves as a protection for the internal organs, excretes waste materials, provides posture and structure to the body, and is responsible for the skin color of a person.
• Eccrine sweat glands are present in the armpits and groin area.
• Excessive dryness, often accompanied by flaking, or excessive sweating (diaphoresis) may indicate a problem.
• In addition to identifying generalized warmth or coolness of the skin, note the temperature of any areas with increased pigmentation or erythema.
• The best area to assess for skin turgor would be on the abdomen.
• Mobility is decreased and cyanosis or jaundice in the skin is obscured.
• Normal skin feels smooth and firm with an even surface.
• In pitting edema the interstitial water is mobile and can be translocated with the pressure exerted by a finger.
• Local warmth of inflammation or cellulitis.
• Normally the skin promptly returns into place.
• Edema may be pitting or nonpitting.
• Carotenemia is the yellow color that accompanies high levels of carotene.
• Decreased mobility in edema, scleroderma; decreased turgor in dehydration.
• Lift a fold of skin and note the ease with which it lifts up (mobility) and the speed with which it returns into place (turgor).
• Jaundice suggests liver disease or excessive hemolysis of red blood cells.
• Dry skin with parched cracked lips, dry mucous membranes, and lack of tears indicate dehydration.
• Generalized warmth in fever, hyperthyroidism; coolness in hypothyroidism.
• Use the backs of your hands to make this assessment.
• Press the skin over a bony prominence and observe the color when your finger is removed.
• Roughness in hypothyroidism; velvety texture in hyperthyroidism.