ATLAND Nursing
Integumentary System and Disorders
Nursing Study Notes
Overview of Anatomy and Physiology
The integumentary system is comprised of the skin, hair, glands, and nails. The skin is the largest
organ of the body.
The main functions of the Integumentary System
1. Acts as a protective barrier against microorganisms, excessive water loss, and injury.
2. Plays a major role in body temperature regulation.
3. Synthesis of vitamin D necessary for bone formation.
4. Acts a sensory organ to pain, heat, or cold stimuli.
5. Excretes water, salts, and organic waste through perspiration.
6. Presents the status of the body’s metabolism, nutrition, and hydration status.
The skin layers
ATLAND Nursing 1 Nursing Study Notes
, 1. The epidermis
This is the skin’s outer layer, which serves as a protective layer to the external
environment.
2. Dermis
This is the middle layer comprising the vasculature, nerves, and glands.
3. The hypodermis/ subcutaneous fat
This is the inner layer comprising of fatty and connective tissues.
Provides heat insulation to the body.
Risk Factors
Infections
Prolonged use of some medications e.g corticosteroids
Improper nutrition
Genetic factors
Age and race
Exposure to toxic conditions- chemical, environmental, radiations, stress
Use of body products harmful to the skin
Disorders affecting the body system
Assessment
1. Take a complete history of the patient and relate it to the risk factors.
2. Assessment of the skin
a. The color- the skin may appear jaundice, pallor, petechiae, cyanosis (check in the lips
in dark people), flushed, erythema, or ecchymosis.
Skin Color Examination Likely cause
Cyanosis Assess the conjunctiva, palm, sole, Hypoxia
tongue, and buccal mucosa for
bluish-gray color.
Pallor Pale in the conjunctiva, nail bed, and Anemia, malnutrition
palms of the hand.
Jaundice Yellow color in the sclera of the eyes, Liver disorders
hands when examined in natural
light.
Erythema Redness of the skin Inflammation
Flushed Redness of the skin Hyperthermia
Petechiae Red-purple dots on the skin surface. Intradermal bleeding due to
thrombocytopenia
Ecchymosis Purple skin discoloration (bruise) Trauma
b. Moisture- usually the skin should be warm and dry, excessively moist skin is
associated with increased sweating.
ATLAND Nursing 2 Nursing Study Notes
, Skin turgor of > 3 seconds is associated with dehydration.
Pitting edema is associated with fluid overload.
c. Temperature- the skin when touched should feel warm.
d. Texture- adults have tougher skin than children; exposed skin surfaces are coarse
compared to unexposed surfaces.
e. Lesions- assess for the lesion's type, size, shape, and characteristics.
Lesion Characteristic Example
Papule An elevated circular area less than 1 cm. Wart, ringworm
Pustule A pus-filled bulla more than 1 cm. Impetigo. acne
Vesicle An elevated fluid-filled collection less than 1 Chickenpox, herpes simplex
cm.
Wheal An elevated collection filled with fluid Hives
Crust A dried area of serum, pus Herpes simplex, Impetigo
Erosion Superficial epidermis loss than is not bleeding Candidiasis
Fissure A narrow crack in the skin Anal fissure, cheilitis
Keloid Elevated scar tissue at the site of skin injury. CS scar, tattoo
Scar Fibrotic tissue changes following wound CS scar, stitch
healing
ATLAND Nursing 3 Nursing Study Notes
Integumentary System and Disorders
Nursing Study Notes
Overview of Anatomy and Physiology
The integumentary system is comprised of the skin, hair, glands, and nails. The skin is the largest
organ of the body.
The main functions of the Integumentary System
1. Acts as a protective barrier against microorganisms, excessive water loss, and injury.
2. Plays a major role in body temperature regulation.
3. Synthesis of vitamin D necessary for bone formation.
4. Acts a sensory organ to pain, heat, or cold stimuli.
5. Excretes water, salts, and organic waste through perspiration.
6. Presents the status of the body’s metabolism, nutrition, and hydration status.
The skin layers
ATLAND Nursing 1 Nursing Study Notes
, 1. The epidermis
This is the skin’s outer layer, which serves as a protective layer to the external
environment.
2. Dermis
This is the middle layer comprising the vasculature, nerves, and glands.
3. The hypodermis/ subcutaneous fat
This is the inner layer comprising of fatty and connective tissues.
Provides heat insulation to the body.
Risk Factors
Infections
Prolonged use of some medications e.g corticosteroids
Improper nutrition
Genetic factors
Age and race
Exposure to toxic conditions- chemical, environmental, radiations, stress
Use of body products harmful to the skin
Disorders affecting the body system
Assessment
1. Take a complete history of the patient and relate it to the risk factors.
2. Assessment of the skin
a. The color- the skin may appear jaundice, pallor, petechiae, cyanosis (check in the lips
in dark people), flushed, erythema, or ecchymosis.
Skin Color Examination Likely cause
Cyanosis Assess the conjunctiva, palm, sole, Hypoxia
tongue, and buccal mucosa for
bluish-gray color.
Pallor Pale in the conjunctiva, nail bed, and Anemia, malnutrition
palms of the hand.
Jaundice Yellow color in the sclera of the eyes, Liver disorders
hands when examined in natural
light.
Erythema Redness of the skin Inflammation
Flushed Redness of the skin Hyperthermia
Petechiae Red-purple dots on the skin surface. Intradermal bleeding due to
thrombocytopenia
Ecchymosis Purple skin discoloration (bruise) Trauma
b. Moisture- usually the skin should be warm and dry, excessively moist skin is
associated with increased sweating.
ATLAND Nursing 2 Nursing Study Notes
, Skin turgor of > 3 seconds is associated with dehydration.
Pitting edema is associated with fluid overload.
c. Temperature- the skin when touched should feel warm.
d. Texture- adults have tougher skin than children; exposed skin surfaces are coarse
compared to unexposed surfaces.
e. Lesions- assess for the lesion's type, size, shape, and characteristics.
Lesion Characteristic Example
Papule An elevated circular area less than 1 cm. Wart, ringworm
Pustule A pus-filled bulla more than 1 cm. Impetigo. acne
Vesicle An elevated fluid-filled collection less than 1 Chickenpox, herpes simplex
cm.
Wheal An elevated collection filled with fluid Hives
Crust A dried area of serum, pus Herpes simplex, Impetigo
Erosion Superficial epidermis loss than is not bleeding Candidiasis
Fissure A narrow crack in the skin Anal fissure, cheilitis
Keloid Elevated scar tissue at the site of skin injury. CS scar, tattoo
Scar Fibrotic tissue changes following wound CS scar, stitch
healing
ATLAND Nursing 3 Nursing Study Notes
