Health assessment

• Four components of a general survey

  • Physical appearance
  • Body Structure
  • Mobility
  • Behavior
• Physical appearance


  Includes age, sex, skin color, facial features, and level of consciousness (AVPU)
• Body Structure


  Includes stature, nutrition, symmetry, posture, position, and body build/contour
• Mobility


  Includes gait and range of motion
• Behavior


  Includes facial expressions, mood and affect, speech, dress, and personal hygiene
• Sample General Survey: Received a client on her mid-forties, and she appears to be in her stated chronologic age. Client is wearing a violet duster and is clean or groomed appropriately for the weather. Stains on hands and dirty nails are evident since during her attack she was rushed from work to the ER for treatment. Client is alert and oriented to what is happening at the time of the interview and physical assessment. Client responds to questions and interacts appropriately. Facial features are symmetric with movement. Client establishes good eye contact when conversing with others. Smiles and frowns appropriately
• Types of skin lesions

  • Macule
  • Papule
  • Plaque / Patch
  • Wheal
  • Cysts
  • Nodules
  • Tumor (neoplasm)
  • Vesicle
  • Bulla
  • Pustule
  • Scale
  • Crusts
  • Lichenification
  • Scar
  • Excoriation
  • Fissure
  • Ulceration
  • Erosion
  • Petechiae or purpura or ecchymosis
  • Telangiectasis
  • Annular "annulus lesion"
  • Serpiginous lesions
  • Flat-Topped lesions
  • Domed shaped lesion
  • Digitate lesion
  • Cerebriform lesion
  • Proteus syndrome
  • Pedunculated lesion
  • Sessile lesion
  • Punctate keratoderma
  • Rolled border lesion
• Macule


  A flat, distinct, discolored area of skin less than 1 centimeter (cm) wide
• Papule


  A circumscribed, solid elevation of skin with no visible fluid
• Plaque / Patch


  A circumscribed, elevated, palpable lesion more than 1 cm in diameter
• Wheal


  A raised, itchy (pruritic) area of skin at times an overt sign of allergy
• Cysts


  A sac that may be filled with air, fluid or other material
• Nodules


  Tender, red swollen bumps
• Tumor (neoplasm)


  Abnormal mass of tissue that may be solid or fluid-filled
• Vesicle


  A small fluid-filled sac within the body
• Bulla


  Large blister containing serous fluid
• Pustule


  Papules with yellowish, liquid pus
• Scale


  Thin piece of the outermost layer of skin resembling a fish scale
• Crusts


  Dried exudate (ie. blood, serum, pus) on the skin surface
• Lichenification


  An increase in skin lines & increases from frequent rubbing
• Scar


  Mark remaining (as on the skin) after injured tissue has healed
• Excoriation


  A loss of skin due to scratching or picking
• Fissure


  A linear crack in the skin; often very painful
• Ulceration


  Deep open wound with partial or complete loss of the dermis or submucosa
• Erosion


  Superficial open wound with loss of epidermis or mucosa only
• Petechiae or purpura or ecchymosis


  Describes red blood cells that are outside the vessel walls & areas are nonblanchable (skin rash that does not fade when pressed with)
• Telangiectasis


  Dilated superficial dermal vessels
• Annular "annulus lesion"


  Ringed, circular or ovoid macules or patches
• Serpiginous lesions


  Signifies it as slowly progressive or "creeping"
• Flat-Topped lesions


  Evenly elevated rash or lesions
• Domed shaped lesion


  Rounded
• Digitate lesion


  Horny with finger-like shape
• Cerebriform lesion


  Resembling the convolutions of the brain surface
• Proteus syndrome


  An overgrowth of the bones, skin, and other tissues
• Pedunculated lesion


  Connected by a stalk. "Skin tags"
• Sessile lesion


  Attached by a broad base as opposed to pedunculated
• Punctate keratoderma


  Abnormal thickening of the palms and soles
• Rolled border lesion


  Curled or rounded edge
• Skin assessment procedures


  • Inspection
  • Palpation
• Inspection


  Visually examining the skin