Advanced Health Assessment: Skin hair and nails
1. Risks of cancer Ans: Risks. Early: painless, non-healing ulcers. Late. enlarged,
hard, non-tender cervical chain, or sub-mental lymph nodes. noticeable mass.
bleeding. loosening of teeth. difficulty wearing dentures. and dysphagia.
2. Eyelids Ans: The thinnest skin normally appears on the
3. Causes of Oral Cancer Ans: Age > 40. Gender is 2 to 1 male-female ratio.
African Americans have highest incidence. Tobacco. Alcohol. Exposure to sunlight.
History of prevoously diagnosed cancer. Immunosupressants.
4. Risk and causes of hearing loss Ans: Age > 50. Environmental noise > 80
dB. Ototoxic medication. Family history. Autoimmune disorders. History of
congenital hearing loss
5. Risk of visual loss Ans: Legally blind when visual acuity is 20/200. Loss of
peripheral field.
6. causes of visual loss Ans: A loss of elasticity of the lens of the eyes with
age aka Presbyopia.
7. Normal findings for nail inspection and palpation Ans: smooth and
rounded. nail surface flat and slightly curved downward at the edges. intact with
same color adjacent skin without edema. nail based is 160 degrees. uniform in
thickness.
,8. Abnormal findings for nail inspection and palpation Ans: Primary lesions.
Beau's lines. Clubbing. Leukonychia. Koilonychia or spoon nail.
9. Beau's lines Ans: grooves or transverse depressions running across the nail
resulting from traumas that temporarily impairs nail formation.
10. Clubbing Ans: when the angle of the nail base exceed 180 degrees caused
by proliferation of the connective tissue, resulting in an enlargement of the distal
fingers. It is commonly associated with chronic respiratory or cardiovascular
disease.
11. Koilonychia Ans: a thin, depressed nail with the lateral edges turned upward
that is associated with anemia or maybe congenital
12. Leukonychia Ans: White spots on the nail plate cause by minor trauma or
manipu- lation of the cuticle.
13. Turgor Ans: Decreased turgidity means skin is low to retract
14. Freckles Ans: NORMAL. normal. Small. Flat. Hyperpigmented macules
that may appear anywahere on the body, particularly on sun-exposed areas.
Face, arms. Back.
15. Assessment of nevi (moles) Ans: NORMAL. Normal. Most adults have 10 -
40 moles scattered all over the body. Above the waist on sun-exposed body
surfaces. UNIFORMLY tan to dark brown. Less than 5 mm in size. RAISED. or
,FLAT. ROUND or OVAL with clearly defined border.
16. Patch Ans: NORMAL. normal. An area of darker skin pigmentation that is
usually brown or tan and typically is present at birth. Birthmarks. Some face, but
others do not.
, 17. Striae Ans: NORMAL. normal. Silver of pink STRETCH MARKS.
Secondary to weight GAIN or PREGNANCY.
18. Melanoma Ans: ABNORMAL. abnormal. Moles located below the waist or on
the scalp or breast are rarely normal moles. A. Asymmetry. Not round or oval. B.
Border. Poorly defined or irregular. C. Color. Uneven, variegated. D. Diameter.
Greater than 6 mm. E. Elevation. Recent change from flat or raised lesion. F.
Feeling. Sensation of itching, tingling, or stinging.
19. Vitiligo Ans: ABNORMAL. abnormal. an acquired condition associated with
the de- velopment of un-pigmented patch of patches. It is more common in dark-
skinned races and thought to be an autoimmune disorder.
20. Hyperpigmentation Ans: Hyper-pigmentation may be associated with
endocrine disorders and autoimmune disorders.
21. DO know lesion characteristics Box 9-2 Ans: Location and Distribution. Is is
local- ized in specific area, around the waist, under a piece of jewelry or
generalized?
A change in. Color?
22. DO know ecchymosis clinical findings pp. 130-131 Ans: Bruise. A
discoloration of the skin or mucous membrane caused by blood seeping into the
tissues as a result of a trauma to the area. 1 - 3 old purple to deep black. 3 - 6 green
1. Risks of cancer Ans: Risks. Early: painless, non-healing ulcers. Late. enlarged,
hard, non-tender cervical chain, or sub-mental lymph nodes. noticeable mass.
bleeding. loosening of teeth. difficulty wearing dentures. and dysphagia.
2. Eyelids Ans: The thinnest skin normally appears on the
3. Causes of Oral Cancer Ans: Age > 40. Gender is 2 to 1 male-female ratio.
African Americans have highest incidence. Tobacco. Alcohol. Exposure to sunlight.
History of prevoously diagnosed cancer. Immunosupressants.
4. Risk and causes of hearing loss Ans: Age > 50. Environmental noise > 80
dB. Ototoxic medication. Family history. Autoimmune disorders. History of
congenital hearing loss
5. Risk of visual loss Ans: Legally blind when visual acuity is 20/200. Loss of
peripheral field.
6. causes of visual loss Ans: A loss of elasticity of the lens of the eyes with
age aka Presbyopia.
7. Normal findings for nail inspection and palpation Ans: smooth and
rounded. nail surface flat and slightly curved downward at the edges. intact with
same color adjacent skin without edema. nail based is 160 degrees. uniform in
thickness.
,8. Abnormal findings for nail inspection and palpation Ans: Primary lesions.
Beau's lines. Clubbing. Leukonychia. Koilonychia or spoon nail.
9. Beau's lines Ans: grooves or transverse depressions running across the nail
resulting from traumas that temporarily impairs nail formation.
10. Clubbing Ans: when the angle of the nail base exceed 180 degrees caused
by proliferation of the connective tissue, resulting in an enlargement of the distal
fingers. It is commonly associated with chronic respiratory or cardiovascular
disease.
11. Koilonychia Ans: a thin, depressed nail with the lateral edges turned upward
that is associated with anemia or maybe congenital
12. Leukonychia Ans: White spots on the nail plate cause by minor trauma or
manipu- lation of the cuticle.
13. Turgor Ans: Decreased turgidity means skin is low to retract
14. Freckles Ans: NORMAL. normal. Small. Flat. Hyperpigmented macules
that may appear anywahere on the body, particularly on sun-exposed areas.
Face, arms. Back.
15. Assessment of nevi (moles) Ans: NORMAL. Normal. Most adults have 10 -
40 moles scattered all over the body. Above the waist on sun-exposed body
surfaces. UNIFORMLY tan to dark brown. Less than 5 mm in size. RAISED. or
,FLAT. ROUND or OVAL with clearly defined border.
16. Patch Ans: NORMAL. normal. An area of darker skin pigmentation that is
usually brown or tan and typically is present at birth. Birthmarks. Some face, but
others do not.
, 17. Striae Ans: NORMAL. normal. Silver of pink STRETCH MARKS.
Secondary to weight GAIN or PREGNANCY.
18. Melanoma Ans: ABNORMAL. abnormal. Moles located below the waist or on
the scalp or breast are rarely normal moles. A. Asymmetry. Not round or oval. B.
Border. Poorly defined or irregular. C. Color. Uneven, variegated. D. Diameter.
Greater than 6 mm. E. Elevation. Recent change from flat or raised lesion. F.
Feeling. Sensation of itching, tingling, or stinging.
19. Vitiligo Ans: ABNORMAL. abnormal. an acquired condition associated with
the de- velopment of un-pigmented patch of patches. It is more common in dark-
skinned races and thought to be an autoimmune disorder.
20. Hyperpigmentation Ans: Hyper-pigmentation may be associated with
endocrine disorders and autoimmune disorders.
21. DO know lesion characteristics Box 9-2 Ans: Location and Distribution. Is is
local- ized in specific area, around the waist, under a piece of jewelry or
generalized?
A change in. Color?
22. DO know ecchymosis clinical findings pp. 130-131 Ans: Bruise. A
discoloration of the skin or mucous membrane caused by blood seeping into the
tissues as a result of a trauma to the area. 1 - 3 old purple to deep black. 3 - 6 green
