NHA week 5

• The skin


  • It is the largest organ of the body
  • It is a physical barrier that protects the underlying tissues and organs from microorganisms, physical trauma, ultraviolet radiation, and dehydration
  • It plays a vital role in temperature maintenance, fluid and electrolyte balance, absorption, excretion, sensation, immunity, and vitamin D synthesis
  • It provides an individual identity to a person's appearance
• The skin


  • It is thicker on the palms of the hands and soles of the feet, and is continuous with the mucous membranes at the orifices of the body
  • It is composed of three layers: the epidermis, dermis, and subcutaneous tissue
• Epidermis


  • The outer layer of skin, the outermost layer consists of dead, keratinized cells that render the skin waterproof
  • The epidermal layer is almost completely replaced every 3 to 4 weeks
  • The major determinant of skin color is melanin
• Dermis

  • The inner layer of skin, a well-vascularized, connective tissue layer containing collagen and elastic fibers, nerve endings, and lymph vessels
  • It is also the origin of sebaceous glands, sweat glands, and hair follicles
• Diseases and disorders of the skin may be local or caused by an underlying systemic condition
• To perform complete and accurate assessment, collect data about current symptoms, the client's past and family history, and lifestyle and health practices
• The information obtained provides clues to the client's overall level of functioning in relation to the skin
• Rash


  A widespread eruption of skin lesions, a very broad medical term with a wide range of appearances and causes
• Establishing normal or baseline data on birthmarks and moles allows future variations to be detected
• Multiple or atypical moles increase one's risk for skin cancer
• A change in the appearance or bleeding of any skin mark, especially a mole, may indicate cancer
• Asymmetry, irregular borders, color variations, diameter greater than 0.5 cm, and elevation are characteristics of cancerous lesions
• Changes in sensation or temperature

  May indicate vascular or neurologic problems such as peripheral neuropathy related to diabetes mellitus or arterial occlusive disease
• Decreased sensation


  May put the client at risk for developing pressure ulcers
• Pruritus


  Itching, may be seen with dry skin, drug reactions, allergies, lice, insect bites, uremia, or obstructive jaundice
• Paresthesia


  Abnormal sensations of tingling, pricking, or burning
• Numbness or dulling of sensations of pain, temperature, and touch to the feet


  May be seen in diabetic peripheral neuropathy
• Some medications


  Can cause photosensitivity reactions after being exposed to the sun
• Uncontrolled body odor or excessive or insufficient perspiration


  May indicate an abnormality of the sweat glands or an endocrine problem such as hypothyroidism or hyperthyroidism
• Perspiration decreases with aging because sweat gland activity decreases
• Because of decreased sweat production, most Asians and Native Americans have mild to no body odor, whereas Caucasians and African Americans tend to have a strong body odor unless they use antiperspirant or deodorant products
• Any strong body odor may indicate an abnormality
• Severe sunburns as a child

  Are a risk factor for skin cancer
• Current problems may be a recurrence of previous ones, and visible scars may be explained by previous problems
• Hospitalization increases the client's risk for a hospital-acquired infection, such as methicillin-resistant
• Various types of allergens can precipitate a variety of skin eruptions
• Some skin rashes or lesions may be related to viruses or bacteria
• Some skin and hair conditions can result from hormonal imbalance
• Over one-third of dermatologic disorders have significant psychiatric comorbidity. Depression often occurs in association with dermatologic disease
• Viruses (e.g., chickenpox, measles) can be highly contagious. Acne and atopic dermatitis tend to be familial. Some allergies may be identified from family history
• A genetic component is associated with skin cancer, especially malignant melanoma
• Ear piercing, if desired, should be performed before age 11 to avoid keloid formation if there is a family history
• Sun exposure can cause premature aging of skin and increase the risk of cancer. Hair can also be damaged by too much sun. Excessive or unprotected exposure to ultraviolet (UV) radiation increases one's risk for skin cancer
• If clients do not know how to inspect the skin, teach them how to recognize suspicious lesions early
• Any of these substances (coal, tar, pitch, creosote, arsenic compounds, or radium) have the potential to irritate or damage the skin, hair, or nails and increase one's risk for skin cancer
• Older, disabled, or immobile clients who spend long periods of time in one position are at risk for pressure ulcers
• Temperature extremes affect the blood supply to the skin and can damage the skin layers. Examples include frostbite and burns
• Piercing needles place clients at risk for infection
• Risks involved with tattooing include infection, painful removal that causes scarring, allergic reactions, formation of granulomas, keloid formation, swelling or burning sensations when undergoing magnetic resonance imagining (MRI)
• There are five major types of tattoos: traumatic, amateur, professional, medical, and cosmetic