RLE 11

• Intact and functioning skin is essential for the life and health of the patient.
• The purpose of the integumentary history is to identify diseases of the skin, systemic 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.
• The teacher directs the student to mark their place in the work tracker, which is a visual to help students track how much work they have accomplished and how much work there is left to do.
• The strategy used in this session is CAT 3-2-1.
• The work tracker will be part of the student activity sheet.
• The closure activity is to evaluate what the students learned after the discussion and the activity.
• In CAT 3-2-1, students are asked to list three things they learned, two things they'd like to learn more about, and one question they still have.
• The patient with an integumentary issue will frequently state the problem when asked the purpose of the visit / the reason for seeking care.
• Trichotillomania is a condition where a person has an irresistible urge to pull out their own hair.
• Tinea Capitis is a type of fungal infection that affects the scalp.
• Stage 4 pressure ulcer extends up to the muscles, bones and supporting tissue.
• Telogen effluvium is a condition where there is excessive hair loss.
• Hair loss from pulling, plucking, or twisting hair is known as alopecia areata.
• The American Cancer Society recommends yearly skin examination as part of a routine cancer-related check-up for those aged 30 or older.
• The nurse can utilize the OLD CART mnemonic to ask follow-up questions in order to obtain a full description of the condition.
• The integumentary examination includes inspecting and palpating the skin, hair, nails, and inspecting the body, axillae and pubic hair.
• Common or concerning symptoms include rash, lesions, non healing lesions, bruising (ecchymosis), moles, hair loss, growths, and nail changes.
• The physical examination of the skin includes inspecting and palpating the skin, hair, nails, and inspecting the body, axillae and pubic hair.
• Skin diseases include acne, psoriasis, eczema, melanoma, and seborrheic dermatitis.
• Pitting edema is measured by a plethysmograph, while non-pitting edema is measured by a percussion device.
• Hair loss on the legs can indicate a hormonal imbalance, hyperthyroidism, peripheral artery disease, or hypothyroidism.
• The Braden Scale is used to assess risk factors for pressure sores.
• Pitting edema is when the indentation is filled when pressure is applied, while non-pitting edema is when the indentation is not filled when pressure is applied.
• The apocrine glands are stimulated by emotional stress, temperature, physical stress, overhydration, and hormonal changes.
• Changes in products, brands, and services should be monitored regularly.
• A score of 9 or lower on the Braden Scale signifies that the patient is at risk for a pressure sore.
• When educating a patient about the risks of malignant melanoma, it is important to include factors such as red or light hair, freckles, immunosuppression, female gender, and age older than 60.
• False nails or wigs, nail salon or gym visits, sun exposure, use of sunscreen, skin self-examinations, exposure to chemicals or radiations, hobbies, and diet are factors that can affect the skin.
• Examining the skin can reveal overhydration, allow early identification of noncancerous lesions, rule out physical abuse, and allow early identification of risk factors for dehydration.
• Hair diseases include alopecia areata, trichotillomania, and telogen effluvium.
• Nail diseases include onychomycosis, paronychia, and leukonychia.
• The health history includes past history, family history, lifestyle and personal habits, and health promotion and counseling.
• The integumentary assessment includes inspecting and palpating the skin, hair, nails, and inspecting the body, axillae and pubic hair.
• Bed sores and its stages are discussed on pages 184-185.
• Health promotion and counseling in the integumentary system includes health education, health promotion, and disease prevention.
• Application instructions include obtaining an integumentary assessment on a classmate or patient using the form below.
• Past history, family history, lifestyle and personal habits, and health promotion and counseling are also discussed on pages 187-209.